血清hs-CRP、TNF-α及VEGF水平对冠心病严重程度的预测价值

The value of serum hs-CRP,TNF-α and VEGF levels in predicting the severity of coronary heart disease

目的分析冠心病患者血清高敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)及血管内皮生长因子(VEGF)水平对病情严重程度的预测价值。方法选择2013年6月—2015年10月四川省自贡市第一人民医院心内科治疗的冠心病患者117例作为研究对象,根据病理类型、病变支数、病变血管狭窄程度分组,另选择同期健康体检者50例作为健康对照组。对各组患者血清hs-CRP、TNF-α及VEGF水平进行检测,并分析其同冠心病严重程度的相关性。结果健康对照组及稳定型心绞痛(SAP)组、不稳定型心绞痛(UAP)组、急性心肌梗死(AMI)组患者的血清hs-CRP、TNF-α及VEGF水平均依次呈上升趋势,4组间比较差异具有统计学意义(P<0.05);随着病变支数的增加,冠心病患者血清hs-CRP、TNF-α及VEGF水平亦呈上升的趋势,组间比较差异具有统计学意义(P<0.05);随着病变血管狭窄程度加重,冠心病患者血清hs-CRP、TNF-α及VEGF水平亦呈上升趋势,组间比较差异具有统计学意义(P<0.05);Pearson相关性分析显示冠心病患者血清hs-CRP与TTNF-α、hs-CRP与VEGF、TNF-α与VEGF水平之间均呈正相关(r=0.649、0.695、0.528,P=0.014、0.008、0.029),并且均与Gensini评分呈正相关(r=0.691、0.557、0.608,P=0.015、0.022、0.019)。结论冠心病患者的血清hs-CRP、TNF-α及VEGF水平明显高于正常水平,并且会随着疾病严重程度的增加而升高,其水平的高低对于冠心病患者的疾病严重程度判断具有肯定的临床参考意义。

Objective To analysis and investigate the value of serum hs-CRP,TNF-αand VEGF levels in predicting the severity of coronary heart disease.Methods One hundred and seventeen cases of patients with coronary heart disease were selected,which were treated in department of cardiology of Zigong First People＆#39;s Hospital from June 2013 to October 2015, and they were divided into different groups according to the pathological type, the number of lesions, the degree of vascular stenosis.Another 50 healthy subjects were selected as the control group.Serum hs-CRP, TNF-αand VEGF levels of each group were measured and the correlation with the severity of coronary heart disease were analyzed.Results The healthy con-trol group and stable angina pectoris（SAP）group, unstable angina pectoris（UAP）group and acute myocardial infarction （AMI）patients＆#39; serum hs-CRP, TNF-αand VEGF levels were successively increased, with significant differences between the 4 groups（P 〈0.05）;with the increase of the number of diseased vessels coronary heart disease,serum hs-CRP,TNF-αand VEGF level were increased,the difference was statistically significant（P 〈0.05）;with the degree of vascular stenosis of coronary heart disease increased,serum hs-CRP, TNF-αand VEGF levels also increased, the difference was statistically significant（P 〈0.05）;Pearson correlation analysis showed that in patients with coronary heart disease,hs-CRP and TNF-α and VEGF levels were positively correlated（r =0.649,r =0.695,r =0.528,P =0.014,P =0.008,P =0.029）, and was positively correlated with Gensini score（r =0.691,r =0.557,r =0.608,P =0.015,P =0.022,P =0.019）.Con-clusion The levels of serum hs-CRP,TNF-αand VEGF in patients with coronary heart disease were significantly higher than those in normal and will increase with the severity of the disease.They show some certain reference values for judging the se-verity of coronary heart disease.