血清可溶性E-选择素、谷氨酰转肽酶联合颈动脉内膜中层厚度检测在冠心病中的诊断价值

Value of serum soluble E-selectin and glutamyl transpeptidase combined with carotid intima-media thickness in the diagnosis of coronary heart disease

目的探究血清可溶性E-选择素、谷氨酰转肽酶(GGT)联合颈动脉内膜中层厚度(IMT)检测在冠心病中的诊断价值。方法选择2015年1月~2017年9月解放军第一一三医院住院治疗的134例冠心病患者作为观察组,其中观察组根据不同类型分为不稳定型心绞痛组44例,急性心肌梗死组49例及稳定型心绞痛组41例,另择同期50名健康体检者作为对照组。比较各组受试者血清可溶性E-选择素、GGT水平及IMT厚度,分析单一指标及联合指标检测的诊断效能。结果观察组血清可溶性E-选择素、GGT水平及IMT厚度均显著高于对照组,差异有统计学意义(P<0.05);不稳定型心绞痛组及心肌梗死组血清可溶性E-选择素、GGT水平及IMT厚度显著高于稳定型心绞痛组(P<0.05);不稳定型心绞痛组GGT水平显著高于心肌梗死组(P<0.05);3种指标联合诊断不稳定型心绞痛、心肌梗死、稳定型心绞痛及冠心病的阳性率分别为95.45%、97.95%、97.56%、97.01%,显著高于其他单一指标检测(P<0.05)。结论血清可溶性E-选择素、GGT、IMT可能与冠心病发生、发展相关,临床上建议三者联合进行冠心病的诊断。

Objective To investigate the value of serum soluble E-seleetin and glutamyl transpeptidase （GGT） combined with carotid intima-media thickness （IMT} in the diagnosis of coronary heart disease. Methods A total of 134 patients with coronary heart disease who hospitalized in the ll3rd Hospital of PLA from January 2016 to September 2017 were selected as the observation group. And according to different types the observation group was divided into subgroups, including 44 patients in unstable angina peetoris group, 49 patients in acute myocardial infarction group and 41 patients in stable angina peetoris group, and 50 healthy people that took physical examinotion in the same period were selected as the control group. Levels of serum soluble E-seleetin, GGT and IMT were compared among the three groups, and the diagnostic effieieneies of single indicator and combined detection were analyzed respectively. Results The levels of serum soluble E-selectin, GGT and IMT in the observation group were significantly higher than those in the control group （P 〈 0.05）. Levels of serum soluble E-seleetin, GGT and IMT in the unstable angina peetoris group and myocardial infarction group were significantly higher than those in stable angina peetoris group （P 〈 0.05）. GGT levels in the unstable angina peetoris group were significantly higher than those in the myocardial infarction group （P 〈 0.05）. The diagnosis positive rate of unstable angina peetoris, myocardial infarction, stable angina pectoris and coronary heart disease diagnosed by the combination of the three indicatorsand development of coronary heart disease. The three indicators are suggested combined to diagnose coronary heartdisease in clinic.