多项新的危险因素与冠心病的相关性研究

THE RESEARCH OF RELEVANCE BETWEEN A NUMBER OF NEW RISK FACTORS AND CORONARY HEART DISEASE

目的:观察冠心病新的危险因素血清脂蛋白(a)[LP(a)]、同型半胱氨酸(Hcy)、胱抑素C(CysC)、总胆红素(TBIL)、血尿酸(SUA)及血浆纤维蛋白原(Fib)水平与冠心病(CHD)类型、血管病变的关系方法实验组为CHD病人共150例,又分为3个亚组即急性心肌梗死(AMI)组50例,不稳定性心绞痛(UAP)组50例及稳定性心绞痛(SAP)组50例。对照组为健康人群30例。外周血测定LP(a)、Hcy、CysC、TBIL、SUA、Fib.结果:(1)将CHD组与对照组比较时发现TBIL水平低于对照组(P<0.05);余5项指标均高于对照组并有统计学意义。(2)对不同亚组将各项指标进行比较时,发现从SAP、UAP到AMI组TBIL逐渐下降,余5项指标水平逐渐增高。Cysc水平AMI组高于SAP组(P<0.01)。Hcy水平3个亚组比较均有统计学意义。Fib水平AMI组高于SAP组(P<0.05);UAP组高于SAP组(P<0.05)。UA水平AMI组高于SAP组(P<0.01);UAP组高于SAP组(P<0.01)。(3)当按冠状动脉不同血管病变组对各项指标进行比较,发现从单支、双支到三支病变组TBIL逐渐下降,余5项指标逐渐增高。TBIL水平三支组低于一支病变组(P<0.01);三支组低于于双支组(P<0.05)。Cysc三支组高于一支组(P<0.05)。Hcy水平3个血管病变组比较均有统计学意义。Lp(a)三支组高于一支组(P<0.05)。结论:这六项指标均与CHD相关。TBIL和LP(a)与冠脉狭窄关系更密切,UA和Fib与斑块不稳定性关系更密切,而Hcy和CysC与这两方面都密切相关。

Objective:To observe the relationship among the type、vessel lesions of coronary heart disease(CHD)and the level of new risk factors that includes serum lipoprotein(a)[LP(a)]、homocysteinemia[Hcy]、cystatin C(CysC)、total bilirubin(TBil)、serum uric acid(SUA)and plasma fibrinogen(Fib).Methods:Experimental group for a total of 150 patients with CHD,is divided into three subgroups that 50 cases of acute myocardial infarction(AMI)group,50 cases of unstable angina pectoris(UAP)group and 50 cases of stable angina pectoris(SAP)group.Control group is made up of 30 cases of healthy people.Experimental group and control group are taken blood determination of LP(a)、Hcy、Cys C、TBIL、SUA and Fib.Results:(1)When comparing the CHD group with the control group,the TBIL level was lower than the control group(P<0.05).The remaining five indexes were higher than the control group and had statistical significance.(2)Compared the indexes with different subgroups,from SAP、UAP to AMI group it was found that TBIL gradually decline,the other 5 indexes level gradually increased.Levels of Cysc of AMI group is higher than the SAP group(P<0.01).Compared three subgroups levels of Hcy all had statistical significance.levels of Fib,the AMI group is higher than the SAP group(P<0.05);the UAP group was higher than the SAP group(P<0.05).Levels of UA,the AMI group is higher than the SAP group(P<0.01);the UAP group was higher than the SAP group(P<0.01).(3)When Compared the indexes among the different coronary artery vascular lesions groups,it was found that TBIL gradually decline,the other five indexes gradually increased from single branch group、double branch group to three branch group.The level of TBIL,three branch group was below single branch group(P<0.01)and lower than the two branch group(P<0.05).The level of Cysc,three branch group was higher than single branch group(P<0.05).Compared three groups levels of Hcy all had statistical significance.The level of Lp(a),three branch group was higher than single branch group(P<0.05).Conclusion:These six indexes are more closely related to CHD.TBIL and LP(a)are related to coronary stenosis,and UA and Fib are more closely related to plaque instability,while Hcy and Cys C are closely related to both.