联合检测Hcy、SAA、hs-CRP和Lp(a)在诊断动脉粥样硬化中的临床意义

Clinical significance of combined detection of homocysteine,amyloid A,hypersensitivity C-reactive protein and lipoprotein a in the diagnosis of atherosclerosis

目的 探讨同型半胱氨酸(Hcy)、淀粉样蛋白A(SAA)、超敏C-反应蛋白(hs-CRP)与脂蛋白a[Lp(a)]联合检测在动脉粥样硬化(AS)诊断中的临床应用价值。方法 选取2021年1月—2022年10月于本院就诊的AS患者75例作为研究组,另外纳入同期在本院健康体检者75例作为对照组。同时根据Gensini评分将研究组分为病情良好组和不良组,检测所有受试者空腹血液中Hcy、SAA、hs-CRP和Lp(a)水平,进一步比较单个指标与联合检测4种指标对动脉粥样硬化的诊断价值。结果 与对照组相比,研究组Hcy、SAA、hs-CRP和Lp(a)水平升高(P<0.05),病情不良组患者Hcy、SAA、hs-CRP和Lp(a)水平高于病情良好组(P<0.05)。Hcy、SAA、hs-CRP和Lp(a)敏感度分别为74.7%、85.3%、78.7%、72.7%,特异度分别为72.0%、81.3%、82.7%、69.3%。四者联合检测敏感度与特异度分别为84.0%、90.7%。结论 血液中Hcy、SAA、hs-CRP和Lp(a)检测在动脉粥样硬化诊断中具有一定的价值,四项联合检测可提高诊断效能,可为临床早期诊疗提供参考依据。

Objective This paper aims to investigate the clinical value of the combined detection of homocysteine(Hcy), amyloid A(SAA), hypersensitivity C-reactive protein(hs-CRP) and lipoprotein a [Lp(a)] in the diagnosis of atherosclerosis(AS). Methods Seventy-five AS patients who visited our hospital from January 2021 to October 2022 were selected as the study group, and 75 patients who underwent physical examination in our hospital during the same period were included as the control group. According to the Gensini score, the study group was divided into a good group and a poor group, and the levels of Hcy, SAA, hs-CRP and Lp(a) in the fasting blood of all subjects were measured, and the diagnostic value of a single index and a combination of four indicators for atherosclerosis was compared. Results Compared with the control group, the levels of Hcy, SAA, hs-CRP and Lp(a) in the study group were increased(P<0.05), and the levels of Hcy, SAA, hs-CRP and Lp(a) in the poor group were higher than those in the good group(P<0.05). The sensitivity of HCY, SAA, HS-CRP and Lp(a) was 74.7%, 85.3%, 78.7% and 72.7%, and the specificity was 72.0%, 81.3%, 82.7% and 69.3%, respectively. The sensitivity and specificity of the combined detection of the four were 84.0% and 90.7%, respectively. Conclusion The detection of Hcy, SAA, hs-CRP and Lp(a) in blood has certain value in the diagnosis of atherosclerosis, and the four combined tests can improve the diagnostic efficiency and provide a reference for the early clinical diagnosis and treatment.