冠心病患者血清胱抑素C的检测意义

The detecting significance of serum Cystatin C in patients with coronary heart disease

目的：观察冠心病患者的血清胱抑素 C（CysC）变化，研究其在冠心病发生发展中的作用以及对临床预后判断的意义。方法选取2013年6月至2015年12月在蚌埠医学院第二附属医院心内科住院经过冠脉造影（CAG）检查确诊为冠心病患者108例，其中稳定型心绞痛（SA）34例、不稳定型心绞痛（UA）42例、急性心肌梗死（AMI）32例，另有40例入选对照组（CAG 为正常）。测定各组 CysC 浓度，另将冠心病组分为高 CysC 及低 CysC 亚组，分析比较两亚组间3个月内主要心血管事件（MACE）发生率。组间均数比较分别用 t 检验和方差分析，计数资料采用χ2检验，P ＜0.05为差异有统计学意义。结果 SA、UA 及 AMI 组 CysC 浓度均高于对照组，其中 UA 组浓度最高，差异有统计学意义，而 AMI 组 CysC 浓度低于 UA 组但高于 SA 组。另外在冠心病患者3个月随访中发现：高浓度 CysC 组 MACE 及心衰发生率有显著升高，差异有统计学意义。结论 CysC 参与了冠心病的发生发展，可成为冠心病患者预后评价的一项重要指标。

Objective：to observe change of coronary heart disease patients with serum cystain c to study its role in de-velopment and progression of coronary heart disease and the significance of clinical prognostic. Methods：108 patients with diagnosed coronary heart disease by coronary angiography were selected at the Second Affiliated Hospital of Bengbu Medical College from June 2013 to December 2015. including 34 cases of stable angina,42 cases of unstable angina,32 cases of a-cute myocardial infarction and another 40 cases in the control group to determine all the groups CysC levels. In addition, coronary heart disease was divided into low and high CysC CysC subgroups to analyze and compare major adverse cardiovas-cular events（MACE）rate between two the subgroups within 3 months. Groups were compared using t tests and ANOVA, count data by usingχ2 test P 〈 0. 05 The difference was statistically significant. Results：SA,AMI and UA group CysC levels were higher than those in the control group,the UA group had the highest concentration,and there was a statistically signif-icant difference,while AMI group CysC levels were lower than the UA group but higher than the SA group. During the 3-month follow-up in patients with coronary heart disease,there was significantly higher incidence of heart failure and MACE, and in the high concentrations of CysC group,there was a statistically significant difference. Conclrsion：CysC is involed in development and progression of coronary heart disease,and is an important indicator of prognosis in the patients with coro-nary artery disease.