胱抑素C及D二聚体水平与急性心肌梗死患者冠状动脉血栓负荷的关系

Study on Relationship of Coronary Artery Thrombus Burden with Levels of Cystatin C and D Dimer in Acute Myocardial Infarction

【目的】探讨血清胱抑素C(cys C)及D二聚体(D-D)水平与急性心肌梗死(AMI)患者冠状动脉血栓负荷的关系。【方法】选取在本院接受冠状动脉造影术(CAG)的50例AMI患者作为观察组,另选50例存在胸痛症状但行CAG检查显示冠脉正常的患者作为对照组,比较两组患者血脂、cys C及D-D水平,并采用受试者工作特征(ROC)曲线分析cys C及D-D对AMI的诊断价值。根据冠状动脉血栓负荷等级将观察组患者分为低血栓负荷组(n=21,血栓分级0~3级)和高血栓负荷组(n=29,血栓分级4~5级),比较两组cys C及D-D水平,并分析其对AMI患者高血栓负荷的诊断价值。【结果】观察组患者的甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)水平高于对照组,高密度脂蛋白胆固醇(HDL-C)水平低于对照组(P<0.05),但两组间总胆固醇(TC)水平比较,差异无统计学意义(P>0.05)。观察组cys C和D-D水平显著高于对照组(P<0.05)。cys C和D-D水平诊断AMI的ROC曲线下面积分别为0.955、0.959。与低血栓负荷组相比较,高血栓负荷组患者的cys C和D-D水平更高(P<0.05)。cys C和D-D水平诊断AMI患者高血栓负荷的ROC曲线下面积分别为0.920、0.928。【结论】cys C和D-D水平在AMI患者中明显上调,且高血栓负荷患者水平更高,其对AMI和高血栓负荷均具有较高的诊断价值。

【Objective】To investigate the relationship of coronary artery thrombus burden with serum cystatin C(cys C)and D-dimer(D-D)levels in patients with acute myocardial infarction(AMI).【Methods】Fifty patients who underwent coronary angiography(CAG)for AMI were selected as the observation group,and another 50 patients with chest pain symptoms but having completely normal CAG results were selected as the control group.The lipid profile,cys C,and D-D levels were compared between the two groups.Receiver operating characteristic(ROC)curve analysis was performed to evaluate the diagnostic value of cys C and D-D for AMI.The observation group was further divided into a low thrombus burden group(n=21,thrombus grades 0-3)and a high thrombus burden group(n=29,thrombus grades 4-5)based on the coronary artery thrombus burden evaluation.The cys C and D-D levels were compared between the two groups,and their diagnostic value for high thrombus burden in AMI patients was analyzed.【Results】The levels of triglycerides(TG)and low-density lipoprotein cholesterol(LDL-C)in the observation group were higher than those in the control group,while the level of high-density lipoprotein cholesterol(HDL-C)was lower(P<0.05).However,there was no significant difference in total cholesterol(TC)levels between the two groups(P>0.05).The levels of cys C and D-D in the observation group were significantly higher than those in the control group(P<0.05).The areas under the ROC curves for cys C and D-D in diagnosing AMI were 0.955 and 0.959,respectively.Compared to the low thrombus burden group,the high thrombus burden group had higher levels of cys C and D-D(P<0.05).The areas under the ROC curves for cys C and D-D in diagnosing high thrombus burden in AMI patients were 0.920 and 0.928,respectively.【Conclusion】cys C and D-D levels are significantly elevated in patients with AMI,and their levels are higher in patients with high thrombus burden.Both cys C and D-D measurement have a high diagnostic value for both AMI and high thrombus burden.