不同类型冠心病患者血清Hcy、TBIL、hs-CRP、尿酸的表达及临床意义

Expression and Clinical Significance of Serum Hcy,TBIL,hs-CRP and Uric Acid in Different Types of Patients with Coronary Heart Disease

目的:探讨不同类型冠心病患者血清同型半胱氨酸(Hcy)、总胆红素(TBIL)、高敏C反应蛋白(hs-CRP)、尿酸的水平及临床意义。方法:选取首都医科大学附属北京地坛医院2015年9月-2018年7月收治的冠心病患者132例为冠心病组,根据临床诊断分为稳定型心绞痛52例(SAP组)、不稳定型心绞痛42例(UAP组)、急性心肌梗死38例(AMI组),另选取50例同时期于我院体检的健康志愿者为对照组,检测各组Hcy、TBIL、hs-CRP、尿酸的水平,采用Pearson相关分析Hcy、TBIL、hs-CRP、尿酸水平之间的相关性,采用Logistic回归分析冠心病的影响因素。结果:冠心病组患者的血清Hcy、hs-CRP、尿酸水平显著高于对照组,TBIL水平显著低于对照组(P<0.05)。AMI、UAP组患者的血清Hcy、hs-CRP、尿酸水平显著高于SAP组,TBIL水平显著低于SAP组(P<0.05),且AMI组患者的血清Hcy、hs-CRP、尿酸水平显著高于UAP组,TBIL水平显著低于UAP组(P<0.05)。经Pearson相关分析显示,Hcy与hs-CRP、尿酸呈正相关,与TBIL呈负相关,hs-CRP与尿酸呈正相关(P<0.05),TBIL与hs-CRP、尿酸无明显相关性(P>0.05)。经Logistic回归分析显示,Hcy、hs-CRP、尿酸、高血压、糖尿病均是冠心病的独立危险因素(P<0.05),TBIL是冠心病的保护因素(P<0.05)。结论:冠心病患者血清Hcy、hs-CRP、尿酸水平升高,TBIL水平降低,Hcy、TBIL、hs-CRP、尿酸与患者的病情相关,也是冠心病的影响因素。

Objective:To investigate the expression and clinical significance of serum homocysteine(Hcy),total bilirubin(TBIL),hypersensitive C-reactive protein(hs-CRP)and uric acid in different types of patients with coronary heart disease.Methods:132 patients with coronary heart disease admitted to Beijing Ditan Hospital Affiliated to Capital Medical University from September 2015 to July 2018 were selected as coronary heart disease group,which were divided into stable angina pectoris(SAP group)of 52 cases,unstable angina pectoris(UAP group)of 42 cases,acute myocardial infarction(AMI group)of 38 cases according to clinical diagnosis,Another 50 healthy volunteers who had physical examination in our hospital at the same time were selected as the control group.The expression levels of Hcy,TBIL,hs-CRP and uric acid were detected,Pearson correlation analysis was used to analyze the correlation between Hcy,TBIL,hs-CRP and uric acid levels,Logistic regression analysis was used to analyze the influence factors of coronary heart disease.Results:The levels of serum Hcy,hs-CRP and uric acid in coronary heart disease group were significantly higher than those in the control group,and the levels of TBIL were significantly lower than that in the control group(P<0.05).The levels of serum Hcy,hs-CRP and uric acid in AMI group and UAP group were significantly higher than those in SAP group,the levels of TBIL were significantly lower than that in SAP group(P<0.05).The levels of serum Hcy,hs-CRP and uric acid in AMI group were significantly higher than those in UAP group,the levels of TBIL were significantly lower than that in UAP group(P<0.05).Pearson correlation analysis showed that Hcy was positively correlated with hs-CRP and uric acid,negative correlation with TBIL,and hs-CRP was positively correlated with uric acid(P<0.05).TBIL was not significantly correlated with hs-CRP and uric acid(P>0.05).Logistic regression analysis showed that Hcy,hs-CRP,uric acid,hypertension and diabetes were independent risk factors of coronary heart disease(P<0.05),and TBIL was the protective factor of coronary heart disease(P<0.05).Conclusion:The serum levels of Hcy,hs-CRP and uric acid increased and TBIL decreased in patients with coronary heart disease.Hcy,TBIL,hs-CRP and uric acid were related to the patient's condition,and were also the influence factors of coronary heart disease.