论文部分内容阅读
目的:探讨血清淀粉样蛋白A(SAA)与冠心病(CHD)发生、病变程度及预后的关系。方法:分析88例CHD和92例对照者临床资料并测定高敏C反应蛋白(hsCRP)和SAA。结果:急性冠状动脉综合征(ACS)患者血清SAA及hsCRP水平高于稳定型心绞痛(SAP)组和对照组(P<0.01),SAA水平与hsCRP水平呈正相关(r=0.807,P<0.01);在Gensini积分位于20～40分及大于40分2组的SAA和hsCRP明显高于Gensini积分小于20分的亚组(P<0.01),但与病变范围无关。以SAA≥4.80mg/L或hsCRP≥3.73mg/L作为异常增高上限,对CHD临床识别的敏感性SAA(80.7%)优于hsCRP(61.4%)。SAA水平增高组血管重建的发生率高于SAA水平正常组,差异有统计学意义(P<0.05)。比较CHD危险因素导致CHD发生的危害性,结果显示:SAA>TC>高血压史>吸烟>年龄。结论:炎症反应贯穿于CHD的发生发展,SAA和hsCRP对冠状动脉病变的严重程度有一定的预测价值。SAA对CHD临床识别的敏感性较高,对于及时发现高危人群具有一定的临床意义,SAA在判断CHD的预后方面可能有一定的临床意义。
Objective: To investigate the relationship between serum amyloid A (SAA) and the occurrence, severity and prognosis of coronary heart disease (CHD). Methods: The clinical data of 88 cases of CHD and 92 controls were analyzed and the high sensitivity C reactive protein (hsCRP) and SAA were measured. Results: Serum levels of SAA and hsCRP in patients with acute coronary syndrome (ACS) were significantly higher than those in patients with stable angina pectoris (SAP) and control (P <0.01). There was a positive correlation between SAA and hsCRP (r = 0.807, ; SAA and hsCRP with Gensini scores of 20-40 and greater than 40 were significantly higher than those with Gensini scores less than 20 (P <0.01), but not with lesion size. SAA ≥ 4.80mg / L or hsCRP ≥ 3.73mg / L as the upper limit of abnormalities, the sensitivity of clinical diagnosis of CHD SAA (80.7%) is better than hsCRP (61.4%). The incidence of revascularization in SAA group was higher than that in SAA group (P <0.05). CHD risk factors compared to the risk of CHD, the results showed: SAA> TC> history of hypertension> smoking> age. Conclusion: Inflammatory reaction runs through the development of CHD. SAA and hsCRP have some predictive value on the severity of coronary artery disease. SAA is highly sensitive to clinical diagnosis of CHD and has certain clinical significance for timely detection of high-risk populations. SAA may have certain clinical significance in judging the prognosis of CHD.