3项指标联合检测在冠心病中的临床意义

The value of clinical application of 3 indexes in coronary heart disease

目的观察冠心病患者外周血中同型半胱氨酸、超敏C反应蛋白和D-二聚体含量的变化,探讨3项指标在冠心病中的临床应用价值。方法选择该院临床确诊的冠心病患者95例,其中急性心肌梗死组(AMI)27例,不稳定型心绞痛组(UAP)42例,稳定型心绞痛组(SAP)26例。另选取该院健康体检者50例作为对照组,分别测定同型半胱氨酸、超敏C反应蛋白和D-二聚体含量。结果 AMI组、UAP组和SAP组同型半胱氨酸含量均明显高于对照组,AMI组和UAP组超敏C反应蛋白、D-二聚体含量均明显高于对照组和SAP组,差异有统计学意义(P<0.05)。SAP组超敏C反应蛋白含量与对照组比较差异有统计学意义(P<0.05),D-二聚体含量与对照组比较差异无统计学意义(P>0.05)。结论同型半胱氨酸、超敏C反应蛋白、D-二聚体含量变化与冠心病的发生、发展密切相关,是冠心病发生的重要危险因素,同时3项指标均能较好地反映冠心病患者的病情,对冠心病的早期诊断、治疗及疗效观察具有重要的临床应用价值。

Objective To observe the level of homocysteine（Hcy）,high sensitive C-reactive protein（hs-CRP）and D-Dimer（D-D）in peripheral blood of patients with coronary heart disease,and to explore their values in clinical diagnosis of the coronary heart disease（CHD）.Methods Total of 95 patients with coronary heart disease were selected including 27 patients with AMI,42 patients with UAP and 26 patients with SAP.50 health examination volunteers were served as contro1.The levels of Hcy,hs-CRP and D-D were measured.Results The levels of Hcy in AMI group,UAP group and SAP group were significantly higher than those in control group（P〈0.05）.The levels of hs-CRP and D-D in AMI group and UAP group were significant higher than control group and SAP group（P〈0.05）.The level of hs-CRP in SAP group was much higher than the control group（P〈0.05）,whereas the level of D-D in SAP group was not significantly different from control group（P〈0.05）.Conclusion The changes of serum levels of Hcy,hs-CRP and D-D are related with the occurrence and development of CHD.The joint detection of Hcy,hs-CRP and D-D can better reflect the severe degree of CHD,and could be helpful for early diagnosis,therapy and prognosis of CHD.