血清学指标在冠心病患者中的水平变化及与冠状动脉病变严重程度的关系研究

Study on the changes in the levels of serological indicators in patients with coronary artery disease and its correlation with the severity of coronary artery lesions

目的探讨血清学指标在冠心病患者中的水平变化及与冠状动脉病变严重程度的关系。方法选取203例冠心病患者为观察组,根据冠状动脉病变支数分为单支病变组(119例)、双支病变组(59例)和三支病变组(25例);另选取同期健康体检者250例为对照组。测定并比较观察组与对照组血清学指标[超敏C反应蛋白(hs-CRP)、同型半胱氨酸(Hcy)、血清胱抑素C(Cys-C)、缺血修饰白蛋白(IMA)、降钙素原(PCT)、生长分化因子-15(GDF-15)、尿白蛋白/肌酐比值(UACR)],比较单支病变组、双支病变组、三支病变组血清学指标水平,采用Pearson相关性分析法对冠心病患者冠状动脉病变严重程度与血清学指标进行相关性分析。结果观察组hs-CRP(11.59±1.21)mg/L、Hcy(27.63±5.23)μmol/L、Cys-C(0.87±0.14)mg/L、IMA(90.68±6.32)U/ml、PCT(61.29±5.89)μg/L、GDF-15(1214.37±43.78)pg/ml均高于对照组的(3.23±0.59)mg/L、(6.03±1.21)μmol/L、(0.72±0.10)mg/L、(62.14±3.98)U/ml、(24.41±4.27)μg/L、(683.69±22.39)pg/ml,差异均有统计学意义(P<0.05)。三支病变组hs-CRP、Hcy、Cys-C、IMA、PCT、GDF-15水平高于单支病变组和双支病变组,双支病变组hs-CRP、Hcy、Cys-C、IMA、PCT、GDF-15水平高于单支病变组,差异均有统计学意义(P<0.05)。Pearson相关性结果表明:冠心病患者冠状动脉病变严重程度与UACR无相关性(P>0.05);与hs-CRP、Hcy、Cys-C、IMA、PCT、GDF-15水平呈正相关(P<0.05)。结论hs-CRP、Hcy、Cys-C、IMA、PCT、GDF-15在冠心病患者中呈高表达,患者冠状动脉病变支数越多,其表达水平越高,且与冠状动脉病变严重程度存在强相关性。

Objective To discuss the changes in the levels of serological indicators in patients with coronary artery disease and its correlation with the severity of coronary artery lesions.Methods 203 patients with coronary artery disease were selected as the observation group,and were divided into single-vessel lesion group(119 patients),double-vessel lesion group(59 patients)and triple-vessel lesion group(25 patients)according to the number of coronary artery lesions,and 250 subjects with healthy physical examination at the same period were selected as the control group.Serological indicators[high-sensitivity C-reactive protein(hs-CRP),homocysteine(Hcy),serum cystatin C(Cys-C),ischaemic modified albumin(IMA),procalcitonin(PCT),growth differentiation factor-15(GDF-15),urinary albumin/creatinine ratio(UACR)]were determined and compared in observation group and control group.The serological indicators of the single-vessel disease group,the double-vessel disease group and the triple-vessel disease group were compared.Pearson correlation analysis was used to analyze the correlation between the severity of coronary artery disease and serological indicators in patients with coronary heart disease.Results The observation group had hs-CRP of(11.59±1.21)mg/L,Hcy of(27.63±5.23)μmol/L,Cys-C of(0.87±0.14)mg/L,IMA of(90.68±6.32)U/ml,PCT of(61.29±5.89)μg/L,GDF-15 of(1214.37±43.78)pg/ml,which were higher than(3.23±0.59)mg/L,(6.03±1.21)μmol/L,(0.72±0.10)mg/L,(62.14±3.98)U/ml,(24.41±4.27)μg/L,and(683.69±22.39)pg/ml in the control group,and the differences were statistically significant(P<0.05).The levels of hs-CRP,Hcy,Cys-C,IMA,PCT,and GDF-15 in the triple-vessel lesion group were higher than those in the single-vessel lesion group and the double-vessel lesion group,and the levels of hs-CRP,Hcy,Cys-C,IMA,PCT,and GDF-15 in the double-vessel lesion group were higher than those in the single-vessel lesion group,and the differences were all statistically significant(P<0.05).Pearson correlation results showed that there was no correlation between the severity of coronary lesions and UACR levels in patients with coronary artery disease(P>0.05).There was a positive correlation with hs-CRP,Hcy,Cys-C,IMA,PCT,and GDF-15 levels(P<0.05).Conclusion hs-CRP,Hcy,Cys-C,IMA,PCT and GDF-15 are highly expressed in patients with coronary heart disease,and the more coronary artery lesions in patients,the higher the expression level,which are strongly correlated with the severity of coronary artery lesions.