Hcy、hs-CRP、BNP、D-二聚体与急性冠状动脉综合征的关系研究

To exammination the correlation of acute coronary syndromes patients and their Hcy,hs-CRP,BNP,D-dimer level

目的研究同型半胱氨酸(Hcy)、超敏C反应蛋白(hs-CPR)、B型利钠肽(BNP)、D-二聚体与急性冠状动脉综合征(ACS)的相关性。方法选择2011年8月至2014年8月240例经冠状动脉造影方法诊断为ACS的患者作为研究对象,依据造影结果,分为不稳定型心绞痛(UAP)以及急性心肌梗死(AMI)组。选取同期就诊并确定为稳定性心绞痛患者120例作为稳定型心绞痛(SAP)组。随机选取体检身体健康者120例作为对照组。对所有患者及对照组的临床资料、血液中Hcy、hs-CRP、BNP以及D-二聚体含量水平进行比较,对所有的患者进行Gensini评分,并对影响Gensini评分的相关因素Hcy、hs-CRP、BNP以及D-二聚体水平进行Logistic回归分析。结果各组之间Hcy、hsCRP、BNP以及D-二聚体四项指标的比较,均是AMI组水平最高,其次依次为UAP组、SAP组、对照组,组间比较差异具有显著性(P<0.05);ACS发生病变血管的支数越多,Hcy、hs-CRP、BNPD-二聚体四项指标的水平越高,差异具有显著性(P<0.05);Hcy、hs-CRP、BNP、D-二聚体水平越高,Gensini评分也越高,差异具有显著性(P<0.05);血液中Hcy、hs-CRP、BNP、D-二聚体四项指标的水平均是ACS的独立影响因素(P<0.05)。结论 ACS患者血液中的Hcy、hs-CRP、BNP、D-二聚体四项指标的水平对病情的早期诊断具有重要的临床价值。

Objective The correlation for acute coronary syndromes patients and their Hcy,hs-CRP,BNP,D-dimer level were researched. Methods To select 240 ACS patients who accepted coronary artery angiography diagnosis and were confirmed from April 2011 to April2014 as the research objects. Based on the angiography results,they were divided into UAP and AMI group. Over the same period,120 cases patients with stable angina were determined as SAP group; Randomly,120 people who participate in the examination in our hospita and confirmed to be healthy were selected as the control group. To make a contrast between the clinical data and blood Hcy,hs-CRP,BNP,D-dimer levels of all patients and the control group. All the patients were scored by Gensini. Furthermore,the relationship between Gensini score and blood Hcy,hs-CRP,BNP,D-dimer levels were analyzed by Logistic regression method. Results Relatively,the blood Hcy,hs-CRP,BNP,D-dimer levels are highest for AMI group,and followed by UAP group,SAP group and control group,the contrast have statistically significant difference（ P 0. 05）. When the sticks occured pathological change for ACS patients increased,four indicators about blood Hcy,hs-CRP,BNP,D-dimer level will be more relevantly,and the difference is statistically significant（ P〈0. 05）. While the blood Hcy,hs-CRP,BNP,D-dimer levels rise,the Gensini score will be also higher. There is statistically significant difference（ P〈0. 05）. Conclusion The levels of blood Hcy,hs CRP,BNP,D-dimer level for the early diagnosis of ACS has important clinical value.