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目的:探讨血清超敏C反应蛋白、脂蛋白(a)、纤维蛋白原、总胆红素和尿酸与冠状动脉病变的关系。方法:对418例行选择性冠脉造影患者,分别测定hs-CRP、LP(a)、Fig、TB和UA水平。根据冠状动脉狭窄情况分为冠状动脉正常组(冠状动脉无狭窄,85例),冠状动脉粥样硬化组(冠状动脉狭窄<50%,93例),冠状动脉单支病变组(仅有一支冠状动脉分支狭窄≥50%,155例)和冠状动脉多支病变组(有一支以上冠状动脉分支狭窄≥50%,85例),同时对其一般临床资料,包括血糖,血脂,血压,吸烟史等情况进行总结分析。结果:冠心病组中有吸烟史,且合并高血压、糖尿病、高脂血症的患者人数要明显高于非冠心病组,二者差别均具有统计学意义,P<0.05。多支病变组和单支病变组的TB水平低于正常组,而其余四项指标均高于正常组,差别均具有统计学意义(P<0.05)。Logistic回归分析表明,除UA外,其他四项均为影响冠状动脉病变的因素,其中hs-CRP的意义最大,OR为1.122。结论:高血糖,高血脂,高血压及吸烟史是冠心病的高危因素。随着冠状动脉病变程度加重,除TB显著降低外,hs-CRP、LP(a)和Fig水平均显著增高。除UA外,其他指标均可作为冠心病的评估预测指标,其中hs-CRP对冠心病的预测价值最高。
Objective: To investigate the relationship between serum high-sensitivity C-reactive protein, lipoprotein (a), fibrinogen, total bilirubin and uric acid and coronary artery disease. Methods: 418 patients with selective coronary angiography were measured hs-CRP, LP (a), Fig, TB and UA levels. According to the situation of coronary artery stenosis, the patients were divided into normal coronary artery group (85 cases without coronary artery stenosis), coronary atherosclerosis group (<50%, 93 cases), single coronary artery disease group Arterial branch stenosis ≥50%, 155 cases) and multi-vessel disease group (more than one coronary artery stenosis ≥50%, 85 cases), and its general clinical data, including blood sugar, blood lipids, blood pressure, smoking history The situation carries on the summary analysis. Results: There was a history of smoking in CHD patients, and the number of patients with hypertension, diabetes and hyperlipidemia was significantly higher than that of non-CHD patients (P <0.05). The TB level in multi-vessel disease group and single vessel disease group were lower than those in normal group, while the other four indicators were higher than those in normal group (P <0.05). Logistic regression analysis showed that except for UA, the other four factors were the factors affecting coronary artery disease, of which the significance of hs-CRP was the largest, OR was 1.122. Conclusion: Hyperglycemia, hyperlipidemia, hypertension and smoking history are risk factors of coronary heart disease. With the severity of coronary artery disease, the levels of hs-CRP, LP (a) and Fig were significantly increased except TB. In addition to UA, other indicators can be used as a predictor of coronary heart disease predictors, of which hs-CRP has the highest predictive value of coronary heart disease.