ACS患者血清25(OH)D、TSH、CRP/ALB比值和PCT水平及其临床意义

The Clinical Study of Relationship of Serum 25(OH)D,TSH,CRP/ALB Ratio and PCT Levels in Patients with Acute Coronary Syndrome

目的 探讨急性冠状动脉综合征(acute coronary syndrome,ACS)患者血清25羟基维生素D[25 OH Vitamin D,25(OH)D]、促甲状腺激素(thyroid stimulating hormone,TSH)、C反应蛋白/白蛋白(C- reactive protein/Albmin,CRP/ALB)比值和降钙素原(procalcitonin,PCT)水平相关性的临床分析。方法 生化法等测定了126例ACS患者,其中67例不稳定性心绞痛(unstable angina pectoris,UAP)和59例急性心肌梗死(acute myocardial infarction,AMI),106例SAP患者和100例正常对照组(normal controls,NC)血清25(OH)D、TSH、CRP/ALB和PCT水平并进行对比性分析。受试者工作特征曲线(receiver operating characteristic curve,ROC curve)评估了ACS患者早期诊断的价值。结果 126例患者较之100例NC、106例SAP患者,血清25(OH)D水平明显降低( P <0.01),血清TSH、CRP/ALB和PCT水平明显增高( P 均<0.01)。ROC曲线显示:血清25(OH)D、TSH、CRP/ALB和PCT的临界值分别为15.36ng/mL、7.64mIU/L、4.36和0.45ng/mL,曲线下面积(area under the curve,AUC)分别为0.853、0.608、0.887和0.918,灵敏度83.0%~88.5%,特异性87.4%~ 92.4%。结论 血清25(OH)D、TSH、CRP/ALB和PCT水平具有早期诊断和鉴别诊断ACS的临床价值。

Objective To conduct clinical analysis of primary risk factors and relationship of serum 25(OH)D,TSH,CRP/ALB ratio and PCT levels in the patients with ACS. Methods The risk factor of smoking,drinking wine,hypertension,hypecholesterolmia and diabetic mellitus were screened in 126 patients with ACS and in 106 patients with SAP.The serum 25(OH)D,TSH,CRP/ALB ratio and PCT levels were determined in 126 patients with ACS(including 67 cases of UAP and 59 cases of AMI patients),in 106 patients with SAP and 100 NC by biochemical analysis and followed by comparative analysis.ROC curve was used to evaluate the early diagnosis value in patient with ACS. Results The(n,%)of smoking,drinking wine,hypertension and hypecholesterolmia in 126 patients with ACS and 106 patients with ASP were significantly increased than those in 100 NC( P all <0.01).The serum 25(OH)D level in 126 patients with ACS was significantly decreased than those in 100 NC and in 106 patients with SAP(all P <0.01),but serum TSH,CRP/ALB ratio and PCT levels were significantly increased(all P <0.01).ROC curve showed the cut off value of 25(OH)D,TSH,CRP/ALB ratio and PCT were 15.36ng/mL、7.64mIU/L,4.36 and 0.45ng/mL,respectively.AUC values were 0.853,0.608,0.887 and 0.918,respectively.Sensitivities were 83.0 to 88.5%,and specificities were 87.8 to 92.4%. Conclusion The risk factors of cardiovascular disease were drinking wine,smoking,hypertension,high cholesterolima and diabetic mellitus.The clinical value of serum 25(OH)D,TSH,CRP/ALB ration and PCT levels were significant in the early and differential diagnosis.