冠心病患者纤维蛋白原、血栓前体蛋白、高浓度脂蛋白(a)及Copeptin水平的变化及临床意义研究

Study on the changes and clinical significance of fibrinogen, thrombus precursor protein, high concentration lipoprotein (a) and Copeptin levels in patients with coronary heart disease

目的探讨冠心病(CHD)患者血浆中纤维蛋白原(Fg)、血栓前体蛋白(TpP)、高浓度脂蛋白(a)[LP(a)]及Copeptin的变化及临床意义。方法选取2015年1月~2016年12月我院收治的173例CHD患者作为观察组,选取同期的80例健康人群作为对照组。观察组中,根据患者不同冠脉病变支数,将其分为单支病变组(n=41)、双支病变组(n=87)、多支病变组(n=45)。比较两组研究对象的临床资料(血脂、血糖、血压水平);比较两组研究对象的血浆Fg、TpP、LP(a)及Copeptin水平;比较不同冠脉病变组患者的血浆Fg、TpP、LP(a)、Copeptin水平;考察观察组患者血浆Fg、TpP、LP(a)、Copeptin水平与Gensini评分的相关性。结果观察组的血清中三酰甘油(TG)、总胆固醇(TC)水平高于对照组,差异有统计学意义(P<0.05);观察组的血清高密度脂蛋白胆固醇(HDL-C)水平低于对照组,差异有统计学意义(P<0.05)。观察组的血浆Fg、TpP、LP(a)、Copeptin水平高于对照组,差异有统计学意义(P<0.05)。不同冠脉病变支数患者中的血浆Fg、TpP、LP(a)、Copeptin水平比较,单支病变组<双支病变组<三支病变组,差异有统计学意义(P<0.05)。CHD血浆Fg、TpP、LP(a)、Copeptin水平与患者Gensini评分均成正相关关系,差异有统计学意义(r=0.6128、0.557、0.702、0.614,P<0.001)。结论CHD患者血浆中Fg、TpP、LP(a)及Copeptin的水平明显高于正常人,其水平高低与患者冠脉病变程度有关。

Objective To investigate the changes and clinical significance of plasma fibrinogen (Fg), thrombus precursor protein (TpP), high concentration lipoprotein (a)(LP[a]) and Copeptin in patients with coronary heart disease (CHD). Methods A total of 173 patients with CHD admitted to our hospital from January 2015 to December 2016 were enrolled as the observation group. Eighty healthy participants in the same period were selected as the control group. In the observation group, patients were divided into single-branch lesion group (n=41), double-branch lesion group (n=87) and multi-branch lesion group (n=45) according to the number of different coronary lesion branches. The clinical data (blood lipid, blood sugar, blood pressure levels) of the two groups were compared. Plasma Fg, TpP, LP(a) and Copeptin levels of the two groups were compared. The levels of plasma Fg, TpP, LP(a) and Copeptin in patients with different coronary lesions were compared. The correlations between plasma Fg, TpP, LP(a), Copeptin levels and Gensini score in the observation group were investigated. Results The levels of triacylylycerol (TG) and total cholesterol (TC) in the serum of the observation group were higher than those of the control group, and the differences were statistically significant (P<0.05). The level of serum high density lipoprotoin cholesterol (HDL-C) in the observation group was lower than that in the control group, and the difference was statistically significant (P<0.05). The levels of plasma Fg, TpP, LP(a) and Copeptin in the observation group were higher than those in the control group, the differences were statistically significant (P<0.05). The levels of plasma Fg, TpP, LP(a) and Copeptin in patients with different coronary lesion branches were compared, single-branch lesion group < double-branch lesion group < multi-branch lesion group, the differences were statistically significant (P<0.05), the plasma levels of Fg, TpP, LP(a), and Copeptin in CHD patient were all positively correlated with Gensini score (r=0.613, 0.557, 0.702, 0.614, P<0.001). Conclusion The levels of Fg, TpP, LP(a) and Copeptin in plasma of CHD patients are higher than those of normal people, and their levels are related to the degree of coronary artery disease in patients.