血清淀粉样蛋白A、C反应蛋白、胱抑素C、脂蛋白(a)、同型半胱氨酸联合检测在冠状动脉粥样硬化性心脏病诊断中的应用价值

Application value of combined detection of serum amyloid A,C-reactive protein,cystatin C,lipoprotein(a)and homocysteine in the diagnosis of coronary atherosclerotic heart disease

目的研究血清淀粉样蛋白A(SAA)、C反应蛋白(CRP)、胱抑素C(CysC)、脂蛋白(a)[LP(a)]联合同型半胱氨酸(Hcy)检测在冠状动脉粥样硬化性心脏病(简称冠心病,CHD)诊断中的应用价值。方法选择2018年5月至2019年8月于我院诊治的CHD患者90例,根据冠脉Gensini积分将冠状动脉损伤程度不同的CHD患者分为轻损组(<20分,30例)、中损组(20~40分,30例)、重损组(>40分,30例)。比较三组的一般资料和血清SAA、CRP、CysC、LP(a)、Hcy水平;分析血清SAA、CRP、CysC、LP(a)及Hcy水平与冠状动脉粥样硬化病变程度的相关性。结果轻、中、重损组的血清SAA、CRP、CysC、LP(a)及Hcy水平呈递增趋势,组间比较,差异显著(P<0.01)。经Pearson相关系数分析,患者血清SAA、CRP、CysC、LP(a)及Hcy水平与冠状动脉粥样硬化病变程度呈正相关(P<0.01)。结论血清SAA、CRP、CysC、LP(a)及Hcy水平均与冠状动脉粥样硬化的发生和发展密切相关,其水平与冠状动脉粥样硬化病变程度呈正相关,说明血清SAA、CRP、CysC、LP(a)及Hcy水平联合检测对患者冠状动脉粥样硬化病变的早期诊断、病程进展及预后评估有重要的临床指导价值。

Objective To study the application value of combined detection of serum amyloid A(SAA),C-reactive protein(CRP),cystatin C(CysC),lipoprotein(a)[LP(a)]and homocysteine(Hcy)in the diagnosis of coronary atherosclerotic heart disease(shorter form:coronary heart disease,CHD).Methods Ninety patients with CHD diagnosed and treated in our hospital from May 2018 to August 2019 were selected.According to Gensini score,CHD patients with different degrees of coronary artery injury were divided into mild injury group(<20 points,30 cases),middle injury group(20-40 points,30 cases)and severe injury group(>40 points,30 cases).The general information and the levels of serum SAA,CRP,CysC,LP(a)and Hcy were compared among the three groups;the correlation between the levels of serum SAA,CRP,CysC,LP(a),Hcy and the severity degree of coronary atherosclerosis were analyzed.Results The levels of serum SAA,CRP,CysC,LP(a)and Hcy in the mild,moderate and severe injury groups showed an increasing trend,and there were significant differences among the three groups(P<0.01).The Pearson correlation coefficient analysis showed that serum SAA,CRP,CysC,LP(a)and Hcy levels were positively correlated with the severity degree of coronary atherosclerosis(P<0.01).Conclusion The levels of serum SAA,CRP,CysC,LP(a)and Hcy are closely related to the occurrence and development of coronary atherosclerosis,and the levels of serum SAA,CRP,CysC,LP(a)and Hcy are positively correlated with the severity degree of coronary atherosclerotic.The combined detection of serum SAA,CRP,CysC,LP(a)and Hcy levels has important clinical guiding value for the early diagnosis,course progress and prognosis evaluation of coronary atherosclerosis of patients.