血清同型半胱氨酸与C反应蛋白在颈动脉硬化诊断中的应用价值

The Application Value of Serum Homocysteine Level and C-reactive Protein in the Diagnosis of Carotid Arteriosclerosis

目的评价血浆同型半胱氨酸(Hcy)与C反应蛋白(CRP)在颈动脉粥样硬化诊断中的应用价值。方法选取2012年4月至2014年4月河池市第一人民医院内科收治的32例颈动脉粥样硬化患者为观察组,同时选取同期在本院体检结果显示无颈动脉粥样硬化的32例健康老年人为对照组,按照血管外超声所测量的颈动脉内膜中层厚度以及斑块特征将观察组分为无斑块组(内膜局限性增厚但无斑块形成)13例和有斑块组(内膜弥漫性增厚并斑块形成)19例,检测观察组与对照组空腹血糖、三酰甘油、血肌酐、胆固醇、血尿素氮、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇水平,并检测两组患者血浆Hcy与CRP的水平。结果两组患者空腹血糖、三酰甘油、血肌酐、胆固醇、血尿素氮、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇比较差异均无统计学意义(P>0.05)。观察组Hcy、CRP均高于对照组[(20.8±7.5)μmol/L比(7.8±1.9)μmol/L,(13.4±4.8)g/L比(2.2±1.0)g/L,P<0.01];无斑块组Hcy与CRP水平显著低于有斑块组[(20.3±4.1)μmol/L比(25.7±4.5)μmol/L,(6.2±1.3)g/L比(17.9±4.4)g/L,P<0.01]。结论在临床上可将血清Hcy及CRP结合起来作为判断颈动脉粥样硬化的发生和发展的一项可靠指标。

Objective To investigate the clinical effects of plasma homocysteine（ Hcy） and C-reactive protein（ CRP） in the diagnosis of carotid atherosclerosis. Methods Total of 32 carotid atherosclerosis patients in Hechi City First People＇ s Hospital from Apr. 2012 to Apr. 2014 were selected as observation group,and 32 healthy elderly for health examination were included as control group. In accordance with carotid intima-media thickness and plaque characteristics measured by extravascular ultrasound the observation group was divided into no plaque subgroup（ intima thickening but no plaque formation） of 13 cases and plaque subgroup（ intima diffuse thickening and plaque formation） of 19 cases. The fasting blood glucose,triglyceride,cholesterol,creatinine,blood urea nitrogen,low-density lipoprotein cholesterol and high-density lipoprotein cholesterol values of the two groups were tested,and the plasma Hcy and CRP level of the two groups were detected as well. Results The differences of fasting blood glucose,triglyceride,serum creatinine,cholesterol,blood urea nitrogen,LDL and HDL between the two groups were not statistically significant（ P〉0. 05）. The plasma Hcy and CRP values of the observation group were statistically higher than those in the control group [（ 20. 8 ± 7. 5） μmol / L vs（ 7. 8 ± 1. 9） μmol / L,（ 13. 4 ± 4. 8） g / L vs（ 2. 2 ± 1. 0） g / L,P 〈0. 01 ]; Hcy and CRP in no plaque group were significantly lower than those in the plaque group[（ 20. 3 ± 4. 1） μmol/L vs（ 25. 7 ± 4. 5） μmol/L,（ 6. 2 ± 1. 3） g/L vs（ 17. 9 ± 4. 4） g/L,P 〈0. 01].Conclusion The serum level of Hcy and CRP can be combined as a reliable indicator of the occurrence and development of carotid atherosclerosis.