冠心病患者Hcy、Fg、hsCRP、D-D水平与肠道菌群相关性的分析

Correlation among serum levels of Hcy,Fg,hsCRP,D-D and intestinal flora in patients with coronary heart disease

目的:探讨冠心病患者同型半胱氨酸(Hcy)、纤维蛋白原(Fg)、高敏C反应蛋白(hsCRP)、D二聚体(D-D)水平与其肠道菌群的相关性。方法:选择我院124例冠心病患者为研究对象(冠心病组),另选择47例健康体检者作为健康对照组。检测并比较两组血清Hcy、Fg、hsCRP、D-D水平及肠道菌群[乳酸杆菌(Lac)、双歧杆菌(Bif)、大肠杆菌(Eco)]水平,分析各血清指标对冠心病的诊断价值及其与肠道菌群的相关性。结果:与健康对照组比较,冠心病组血清Hcy[(15.25±5.74)μmol/L比(21.73±6.02)μmol/L]、Fg[(3.24±1.26)g/L比(4.43±1.32)g/L]、hsCRP[(5.74±2.51)mg/L比(9.19±3.67)mg/L]、D-D[(0.51±0.15)mg/L比(0.66±0.23)mg/L]水平显著升高,Lac[(31.83±0.52)CFU/g比(27.97±0.47)CFU/g]、Bif[(26.39±0.16)CFU/g比(25.51±0.23)CFU/g]、Eco[(26.14±0.49)CFU/g比(23.28±0.41)CFU/g]水平均显著降低,P均=0.001;血清Hcy诊断冠心病的价值最高,曲线下面积(AUC)为0.777,最佳截断值下诊断敏感度为81.45%,特异度为65.96%;Pearson相关分析显示Hcy、Fg、hsCRP、D-D水平分别与Lac、Bif、Eco呈显著负相关(r=-0.584~-0.408,P均=0.001)。结论:冠心病患者血清Hcy、Fg、hsCRP、D-D水平与肠道菌群水平呈显著负相关,纠正肠道菌群紊乱可作为冠心病的辅助治疗方法。

Objective:To explore the correlation among serum levels of homocysteine(Hcy),fibrinogen(Fg),high sensitive C-reactive protein(hsCRP),D-dimer(D-D)and intestinal flora in patients with coronary heart disease(CHD).Methods:A total of 124 CHD patients from our hospital were enrolled as CHD group,another 47 healthy subjects were regarded as healthy control group.Serum levels of Hcy,Fg,hsCRP,D-D,and intestinal flora[Lactobacillus(Lac),Bifidobacterium(Bif),Escherichia coli(Eco)]were measured and compared between two groups,diagnostic value of above serum indexes for CHD and their correlation with intestinal flora were analyzed.Results:Compared with healthy control group,there were significant rise in serum levels of Hcy[(15.25±5.74)μmol/L vs.(21.73±6.02)μmol/L],Fg[(3.24±1.26)g/L vs.(4.43±1.32)g/L],hsCRP[(5.74±2.51)mg/L vs.(9.19±3.67)mg/L],D-D[(0.51±0.15)mg/L vs.(0.66±0.23)mg/L],and significant reductions in levels of Lac[(31.83±0.52)CFU/g vs.(27.97±0.47)CFU/g],Bif[(26.39±0.16)CFU/g vs.(25.51±0.23)CFU/g],Eco[(26.14±0.49)CFU/g vs.(23.28±0.41)CFU/g]in CHD group,P=0.001 all;serum Hcy possessed the highest diagnostic value for CHD,area under curve(AUC)was 0.777,sensitivity and specificity was 81.45%,65.96%respectively at cutoff point;Pearson correlation analysis indicated that serum levels of Hcy,Fg,hsCRP and D-D were significant inversely correlated with levels of Lac,Bif and Eco(r=-0.584~-0.408,P=0.001 all).Conclusion:Serum levels of Hcy,Fg,hsCRP,D-D are significantly inversely correlated with intestinal flora in CHD patients.Correcting intestinal flora disorder may be used as a auxiliary therapeutic method for CHD.