脂蛋白（a）、同型半胱氨酸、超敏C-反应蛋白在冠心病中的应用和临床价值研究

Application and clinical value of lipoprotein （a）, homocysteine, hypersensitive c-reactive protein in coronary heart disease

目的：探讨脂蛋白（ a）、同型半胱氨酸（ HCY）、超敏C-反应蛋白（ hs-CRP）三指标在冠心病中的应用和临床价值。方法将284名冠心病患者按照临床类型不同分为稳定型心绞痛（ SAP）组、不稳定型心绞痛（ UAP）组和心肌梗死（ AMI）组，并以209例健康体检者作为健康对照组，采用免疫比浊法对冠心病各组和健康对照组的血清脂蛋白（ a）、HCY、hs-CRP浓度进行检测，对所得计量资料进行统计学分析。对冠心病各分组中血清脂蛋白（LP）（a）、HCY、hs-CRP单个指标及三指标联合检测阳性率进行统计分析。结果冠心病各组血清LP（a）、HCY、hs-CRP浓度均值显著高于健康对照组，差异有统计学意义（P〈0.05）。冠心病各组中该三项指标联合检测阳性率明显高于单一指标的检测，差异有统计学意义（P〈0.05）。结论血清LP（a）、HCY、hs-CRP与冠心病的发生、发展密切相关，三者联合检测有利于冠心病的早发现、早诊断，早干预。三指标在冠心病的预防、风险评估、辅助诊断、及预后中有重要临床意义。

Objective To investigate the application and clinical value of lipoprotein （ a） , homocysteine （ HCY） and hypersensitive c-reactive protein （ hsCRP ） in coronary heart disease （ CHD ） . Methods According to the different clinical types, two hundrad and eighty-four patients with coronary heart disease （ CHD） were divided into three groups （ stable angina pectoris group, unstable angina pectoris group and myocardial infarction group） , and 209 cases of healthy people as the control group. The serum concentration levels of lipoprotein （ a） , HCY and hsCRP in each group were detec-ted through immunoturbidimetric assay. Results The concentration levels of lipoprotein （a）, HCY and hsCRP in each CHD group were significantly higher than those in control group （P〈0. 05）. Meanwhile, the three factors combined detec-tion in coronary heart disease CHD group were significantly higher than that of single factor （P〈0. 05）. Conclusions Se-rum LP （ a） , HCY, HsCRP is closely correlated with the occurrence and development of coronary heart disease （ CHD） , and combined detection is helpful for the early detection, diagnosis and intervention of CHD. The three factors have impor-tant clinical value in prevention, risk assessment, and auxiliary diagnosis, and prognosis of CHD.