PCSK9及Hcy水平对冠心病患者的临床意义

Clinical Significance of PCSK9 and Hcy Levels in Patients with Coronary Heart Disease

目的探讨前蛋白转化酶枯草溶菌素9(PCSK9)及同型半胱氨酸(Hcy)在冠心病患者中的变化及其临床意义。方法选取2019年2月~9月我院收治的冠心病患者84例作为实验组,包括稳定性心绞痛(SAP)、不稳定性心绞痛(UAP)及急性心肌梗死(AMI)患者,另选取同期在我院体检的健康体检者43例作为对照组,比较两组甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白A1(ApoA1)、载脂蛋白B(ApoB)、PCSK9及Hcy水平,比较SAP、UAP及AMI患者PCSK9水平。结果实验组TC、LDL-C、Hcy及PCSK9水平均高于对照组,HDL-C低于对照组,差异均有统计学意义(P<0.05);两组TG、ApoA1、ApoB水平比较,差异无统计学意义(P>0.05);AMI患者血清PCSK9水平为(4.21±0.33)g/L,高于UAP患者的(3.58±0.35)g/L和SAP患者的(2.12±0.79)g/L,且UAP患者高于SAP患者,差异有统计学意义(P<0.05)。结论血浆Hcy、PCSK9水平上升可用于评估冠心病的严重程度,特别是PCSK9可辅助诊断急性冠脉综合征。

Objective To investigate the changes and clinical significance of proprotein convertase subtilisin 9(PCSK9)and homocysteine(Hcy)in patients with coronary heart disease.Methods 84 patients with coronary heart disease admitted to our hospital from February to September 2019 were selected as the experimental group,including patients with stable angina pectoris(SAP),unstable angina pectoris(UAP)and acute myocardial infarction(AMI).43 healthy medical examinees in the hospital as a control group were compared triglyceride(TG),total cholesterol(TC),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),The levels of apolipoprotein A1(ApoA1),apolipoprotein B(ApoB),PCSK9 and Hcy levels were compared with those of SAP,UAP and AMI patients.Results The levels of TC,LDL-C,Hcy,and PCSK9 in the experimental group were higher than those in the control group,and HDL-C was lower than that in the control group,the differences were statistically significant(P<0.05);There was no significant difference in the levels of TG,ApoA1 and ApoB between the two groups(P>0.05);the serum PCSK9 level of AMI patients was(4.21±0.33)g/L,which was higher than that of UAP patients(3.58±0.35)g/L(2.12±0.79)g/L in SAP patients,and UAP patients were higher than SAP patients,the difference was statistically significant(P<0.05).Conclusion The increase of plasma Hcy and PCSK9 levels can be used to assess the severity of coronary heart disease,especially PCSK9 can help diagnose acute coronary syndrome.