维生素D/甲状旁腺激素在急性冠脉综合征中的变化及与髓过氧化物酶、C-反应蛋白的相关性

Changes of vitamin D/parathyroid hormone in acute coronary syndrome and its correlation with myeloperoxidase and C-reactive protein

目的探讨维生素D/甲状旁腺激素(Vitamin D/parathyroid hormone,VitD/PTH)在急性冠脉综合征(acute coronary syndrome,ACS)患者中的变化,探讨VitD/PTH与髓过氧化物酶(myeloperoxidase,MPO)、C-反应蛋白(creactive protein,CRP)的关系,寻找预测ACS的早期标志物,以达到对急性冠脉综合征患者的早期诊断和早期治疗。方法将诊断为冠心病的102例患者分为ACS组(41例)和稳定型心绞痛组(SAP组,38例)。23例冠脉造影正常者为对照组(CG)。测定、比较3组研究对象的血清VitD/PTH、血浆MPO、CRP水平,分析所有研究对象的这些指标的相关性,同时分析VitD/PTH、MPO、CRP与其他传统危险因素的关系。结果 ACS组血清VitD/PTH显著低于SAP组和CG组,差异有统计学意义(P <0. 01); SAP组与CG组之间差异无统计学意义(P> 0. 05);血浆MPO浓度和CRP显著高于SAP组和CG组,差异有统计学意义(P <0. 01); SAP组与CG组之间差异无统计学意义(P> 0. 05)。直线相关分析表明血清VitD/PTH与MPO、CRP呈负相关(P <0. 05),MPO与CRP呈正相关(P <0. 05),与高密度脂蛋白胆固醇(HDL-C)负相关(P <0. 05)。结论血清VitD/PTH水平在ACS组患者中显著降低,而血浆MPO、CRP在ACS患者中显著升高,同时检测可作为更好判断ACS的早期诊断指标物,为患者病情严重程度提供诊断依据。

Objective To investigate the changes of vitamin D/parathyroid hormone （VitD/PTH） in patients with acute coronary syndrome （ ACS ）, and to explore the relationship between VitD/PTH and myeloperoxidase （ MPO ） and C-reactive protein （CRP） , so as to find early markers of ACS for early diagnosis and treatment of patients with ACS. Methods A total of 102 patients diagnosed with coronary heart disease were divided into ACS group （n = 41 ） and stable angina pectoris （SAP） group （n = 38）. Twenty-three patients with normal coronary angiography served as the control group （CG）. Serum VitD/PTH, plasma MPO, and CRP levels were measured and compared among the three groups. The correlation of these indicators was analyzed in all subjects, and the relationship between VitD/PTH, MPO, CRP and other traditional risk factors was analyzed. Results The serun levels of VitD/PTH in ACS group were significantly lower than those in SAP group and those in CG group （P 〈 0.01 ） ,however, there were no significant differences between the SAP group and the CG （P 〉 0.05）. Plasma MPO concentration and CRP were significantly higher in the ACS group than those in SAP group and CG, group （P 〈 0. 01 ）. No significant difference was observed between the SAP group and CG group （P 〉 0. 05）. Linear correlation analysis showed that serum VitD/PTH was negatively correlated with MPO and CRP. In addition, MPO was positively correlated with C RP, but negatively correlated with high density lipoprotein cholesterol （HDLC）. Conclusion The serum levels of VitD/PTH are significantly decreased in patients with ACS, while plasma MPO and CRP are significantly increased in patients with ACS. Simultaneous detection can be used as an early diagnostic indicator for better judgment of ACS, thereby providing a diagnostic basis for the severity of the disease.