血清胱抑素C对冠心病患者血管病变支数及预后的评估价值

Clinical value of serum cystatin C in evaluating the coronary lesion vessels and prognosis of coronary artery disease

目的:探讨血清胱抑素C(Cys-C)水平与冠心病血管病变支数及预后的关系。方法:收集衢州市人民医院心血管内科冠心病患者173例,根据冠状动脉造影结果将患者分为单支病变组、双支病变组和三支病变组,比较组间参数差异并行相关性分析及回归分析。结果:三支病变组较双支病变组及单支病变组血清尿酸水平更高、高密度脂蛋白水平更低(P=0.014、0.044);双支病变组、三支病变组Cys-C表达水平分别较单支病变组显著升高(P=0.016、0.002);血清高密度脂蛋白和Cys-C水平是影响冠状动脉病变支数的相关因素(P=0.010、0.042);血清Cys-C水平与左室射血分数(LVEF)呈负相关(r=-0.462,P<0.001),与年龄、高敏C反应蛋白、脑钠肽(BNP)及同型半胱氨酸水平呈正相关(r=0.535,P<0.001;r=0.199,P=0.009;r=0.537,P<0.001;r=0.665,P<0.001)。结论:冠心病患者血清Cys-C水平在冠状动脉双支病变及三支病变时显著升高,并在评价疾病风险分层及预后评估中具有临床指导意义。

Objective:To investigate the role of serum cystatin C(Cys-C)in evaluating the coronary lesion vessels and prognosis of coronary artery disease(CAD).Methods:One hundred and seventy-three patients with CAD were recruited.The baseline data were collected and the serum Cys-C levels were measured.According to the results of coronary angiography,the patients were categorized into three subgroups:the single-vessel,the doublevessel and the three-vessel.The results among the groups were compared,with the correlation and regression analysis.Results:The three-vessel group had higher uric acid and lower high density lipoprotein(HDL)levels than the single-vessel group and the double-vessel group(P=0.014,0.044).The serum Cys-C level in the doublevessel and the three-vessel groups was significantly higher than that in the single-vessel group(P=0.016,P=0.002).Serum HDL and Cys-C levels were related to the coronary artery lesions(P=0.010,P=0.042).The serum Cys-C level was negatively correlated with left ventricular ejection fraction(LVEF)(r=-0.462,P<0.001),but positively correlated with age,high-sensitivity C-reactive protein,brain natriuretic peptide and homocysteine levels(r=0.535,P<0.001;r=0.199,P=0.009;r=0.537,P<0.001;r=0.665,P<0.001).Conclusion:The serum Cys-C level in the double-vessel and the three-vessel groups was significantly higher than that in the single-vessel group,which has clinical significance in risk stratification and prognosis evaluation.