血清同型半胱氨酸和唾液酸联合检测对急性冠状动脉综合征诊断的意义  

Clinical significance of measurement of serum homocysteine and sialic acid levels in patients with acute coronary syndrome

作　　者：邢跃雷[1] 郭广宏[1] 董振南[1] 田亚平[1] 

机构地区：[1]中国人民解放军总医院生化科,北京100853

出　　处：《国际检验医学杂志》2012年第5期519-520,523,共3页International Journal of Laboratory Medicine

基　　金：国家科技支撑计划课题(2008BAD96B11)

摘　　要：目的研究血清同型半胱氨酸(Hcy)及唾液酸(SA)对急性冠状动脉综合征(ACS)的诊断价值和临床意义。方法以31例急性心肌梗死(AMI)患者(AMI组)、35例不稳定型心绞痛(UA)患者(UA组)及53例体检健康者(对照组)作为研究对象,测定Hcy、SA及包括总胆固醇(CH)、三酰甘油(TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、载脂蛋白AⅠ(ApoAⅠ)、载脂蛋白B(APOB)及脂蛋白(a)[LP(a)]在内的血脂指标。采用统计学方法分析相关指标。结果 AMI组血清Hcy及SA水平高于UA组及对照组(P<0.05);UA组血清Hcy及SA水平高于对照组(P<0.05);除ApoAⅠ外,其余血脂指标的血清浓度在各组间的差异均无统计学意义(P>0.05)。在本研究所有的生物标志中,仅血清Hcy和SA与AMI或UA的发生有关(P<0.05)。血清SA单独检测诊断AMI/UA的ROC曲线下面积分别为94.2%/94.5%,远高于血清Hcy诊断AMI/UA时的ROC曲线下面积84.4%/76.7%。联合血清Hcy后,血清SA对AMI或UA的诊断水平得到进一步的加强。结论测定血清Hcy和SA水平对ACS的预防及治疗监测具有重要的临床意义,两者的联合检测可提高对ACS的诊断水平。Objective To investigate and discuss the diagnostic values of serum homocysteine and sialic acid in patients with acute coronary syndrome,which comprised acute myocardial and unstable angina in this study.Methods 31 cases of acute myocardial infarction （AMI）,35 cases of unstable angina （UA）,and 53 cases of healthy control were included into this study.The serum levels of Hcy,SA and serum lipids which was consisted of CH,TG,HDL,LDL,ApoAⅠ ApoB and Lp（a）,were measured.Results The levels of serum Hcy and SA in AMI were significantly higher than in the healthy control and in UA,meanwhile the serum level of these two biomarkers in UA were also high,compared to the healthy control.However,except APOAⅠ,serum levels of the other lipids had no significant difference among 3 groups.For AMI,area under ROC curves （AUC） values of serum SA for AMI and UA were 94.2% and 94.5%,which were great higher than of serum Hcy （84.4% for AMI and 76.7% for UA）.However,combined serum Hcy,the diagnostic ability of serum SA for AMI or UA could be highly improved.Conclusion The measurement of the levels of the serum Hcy and SA could have important clinical significance in prevention,treatment and monitoring for ACS.Combination of serum Hcy and serum SA could furthen enhance the diagnostic vaule of ACS.

关 键 词：急性冠状动脉综合征 同型半胱氨酸 唾液酸 

分 类 号：R541.4[医药卫生—心血管疾病]