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目的研究超敏C反应蛋白(hsCRP)和YKL-40与冠状动脉病变程度的关系。方法采用Judkins法进行冠状动脉造影,确诊冠心病259例及冠状动脉造影结果正常的对照组251例。应用酶联免疫法测定hsCRP和YKL-40浓度。冠状动脉病变分为1支病变(123例),2支病变(68例)和3支病变组(68例)。采用病例对照的方法进行研究。结果 YKL-40对冠心病易感性预测的受试者特征工作曲线(ROC)下面积(AUC)为0.671[95%可信区间(CI)为1.00-1.02;P<0.01];hsCRP对冠心病易感性预测的AUC为0.778(95%CI为1.24-1.50;P<0.01)。冠心病3支血管病变组血浆hsCRP和YKL-40水平明显高于1支、2支血管病变组(P<0.05或P<0.01);3支血管病变组血浆YKL-40水平明显高于2支血管病变组(P<0.05),而hsCRP在该两组间未见明显差异。在对体重指数(BMI)、高血压史、糖尿病史、吸烟史、高脂血症、TC、LDL-C、hsCRP和YKL-40调整后发现,hsCRP、YKL-40是冠心病最显著的独立相关危险因素(OR=1.37,95%CI为1.24-1.50,P<0.01;OR=1.01,95%CI为1.00-1.02,P<0.01)。结论 hsCRP、YKL-40与冠心病之间有显著相关性。
Objective To study the relationship between hsCRP, YKL-40 and the severity of coronary artery disease. Methods The coronary angiography was performed by the method of Judkins, including 259 cases of coronary heart disease and 251 cases of normal coronary angiography. The hsCRP and YKL-40 concentrations were determined by enzyme-linked immunosorbent assay. Coronary artery lesions were divided into one lesion (123 cases), two lesions (68 cases) and three lesions (68 cases). A case-control study was conducted. Results The area under the receiver operating characteristic curve (ROC) of YKL-40 in predicting coronary heart disease susceptibility was 0.671 [95% confidence interval (CI) = 1.00-1.02; P <0.01]. The effect of hsCRP on coronary heart disease Predicted susceptibility AUC was 0.778 (95% CI 1.24-1.50; P <0.01). The levels of plasma hsCRP and YKL-40 in 3 patients with coronary artery disease were significantly higher than those in 1 patient and 2 patients with vascular disease (P <0.05 or P <0.01). The plasma levels of YKL-40 in 3 patients with vascular disease were significantly higher than those in 2 patients Vascular lesions group (P <0.05), hsCRP no significant difference between the two groups. After adjusting for body mass index (BMI), history of hypertension, history of diabetes, smoking history, hyperlipidemia, TC, LDL-C, hsCRP and YKL-40, hsCRP and YKL-40 were the most significant independent factors of coronary heart disease Associated risk factors (OR = 1.37, 95% CI 1.24-1.50, P <0.01; OR = 1.01, 95% CI 1.00-1.02, P <0.01). Conclusion There is a significant correlation between hsCRP, YKL-40 and coronary heart disease.