冠状动脉粥样硬化性心脏病患者血清总胆汁酸、超敏C反应蛋白、同型半胱氨酸、血脂水平变化的相关性研究

Research on the correlation of serum total bile acid,high sensitive C reactive protein,homocysteine and lipid level changes in patients with coronary atherosclerotic heart disease

目的了解总胆汁酸(TBA)、超敏C反应蛋白(hs-CRP)、同型半胱氨酸(Hcy)、血脂联合检测对冠状动脉粥样硬化性心脏病(CHD)患者的相关性。方法 1 342例健康体检者作为对照组,1 398例经临床确诊的CHD患者作为CHD组,采用全自动生化分析仪测定TBA、hs-CRP、Hcy、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDLC)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白A1(Apo A1)、载脂蛋白B(Apo B))。结果与对照组比较,CHD组TBA、hs-CRP、Hcy、TC、TG、LDL-C、Apo B升高,HDL-C、Apo A1、Apo A1/Apo B、HDL-C/LDL-C、HDL-C/TC降低,差异有统计学意义(P<0.05);经多元回归分析:CHD组TBA与hs-CRP、Hcy、TC、TG、LDL-C、Apo B呈正相关;与HDL-C、Apo A1呈负相关;且与冠脉病变程度密切相关。结论 TBA、hs-CRP、Hcy升高、脂代谢异常与CHD关系密切,提示高水平TBA、hs-CRP、Hcy及脂代谢异常是CHD发病的危险因素,临床上早期干预有可能是预防和治疗高脂血症患者减少CHD发生的重要措施。

Objective To investigate the correlation of the total bile acid（ TBA）,high sensitive C reactive protein（ hs-CRP）,homocysteine（ Hcy）,lipids combined detection in patients with coronary atherosclerotic heart disease（ CHD）. Methods 1 342 healthy examination people were selected as the control group,and 1 398 clinically diagnosed CHD patients were selected as CHD group; using automatic biochemical analyzer to measure the TBA,hs-CRP,Hcy,total cholesterol（ TC）,triglyceride（ TG）,high density lipoprotein cholesterol（ HDL-C）,low density lipoprotein cholesterol（ LDL-C）,apolipoprotein A1（ Apo A1）,apolipoprotein B（ Apo B）. Results Compared with the control group,the TBA,hs-CRP,Hcy,TC,TG,LDL-C,Apo B levels of the the CHD group increased,while the HDL-C,Apo A1,Apo A1 / Apo B,HDL-C / LDL-C,HDL-C / TC levels decreased,and the differences were statistically significant（ P〈0. 05）. According to multiple regression analysis,TBA of CHD group was positively correlated with hs-CRP,Hcy,TC,TG,LDL-C,Apo B,and negatively correlated with HDL-C and Apo A1,and closely related to the degree of coronary artery disease. Conclusion TBA,hs-CRP,Hcy levels increasing and lipid metabolism are closely related to CHD,which indicate that high levels of TBA,hs-CRP,Hcy and lipid metabolism are risk factors for CHD. Clinically early intervention may be an important measure for the prevention and treatment of hyperlipidemia patients to reduce the CHD occurrence.