急性冠脉综合征患者血清胱抑素C,同型半胱氨酸和急性时相C反应蛋白水平及其影响因素研究  

Study on the levels and influencing factors of serum cystatin C,homocysteine and acute phase C reactive protein in patients with acute coronary syndrome

作　　者：吕国龄[1] 霍正禄[1] 

机构地区：[1]上海长海医院急诊科,上海200433

出　　处：《实用临床医药杂志》2013年第11期12-14,共3页Journal of Clinical Medicine in Practice

基　　金：中国高校医学期刊临床专项资金(11320130)

摘　　要：目的探讨血清胱抑素C(Cystatin C)、同型半胱氨酸(Hcy)和急性时相C反应蛋白(Hs-CRP)在急性冠脉综合征患者血清中的水平及其影响因素。方法急性心肌梗死患者30例为急性心梗组,不稳定心绞痛患者35例为不稳定心绞痛组,排除冠心病诊断的患者20例为对照组。检测3组患者血清中Cystatin C、Hs-CRP、Hcy水平。同时检测3组患者血低密度脂蛋白(LDL)、高密度脂蛋白(HDL)、甘油三酯(TG)、总胆固醇(TC)的水平,并记录患者高血压病史、糖尿病史、目前吸烟史等情况。结果急性心梗组和不稳定心绞痛组的H-sCRP、Hcy水平明显高于对照组,LDL、HDL水平明显低于对照组;急性心梗组Cystatin C、TC水平明显低于对照组;不稳定心绞痛组Cystatin C水平明显高于对照组;各组TG水平无显著差异。糖尿病、吸烟史、高血压史对Hcy水平变化均有影响,对Hs-CRP、Cystatin C水平变化无影响。结论急性冠脉综合征患者血清Hcy、Hs-CRP、Cystatin C浓度变化在一定程度上反映了动脉粥样斑块的稳定性。Objective To explore the levels and influencing factors of serum cystatin C （Cystatin C）, homocysteine （Hcy） and acute phase hyper-sensitivity C reactive protein （Hs-CRP） in patients with acute coronary syndrome （ACS）. Methods Thirty patients with acute myocardial infarction were considered as acute myocardial infarction group, 35 patients with unstable angina pectoris as unstable angina pectoris group, and 20 patients excluded the diagnosis of coronary artery disease as control group. The levels of cystatin C, Hs-CRP, Hcy, low density lipoprotein （LDL）, high density lipoprotein （HDL）, triglyceride （TG） and total cholesterol （TC） in patients of 3 groups were detected, and the history of hypertension, diabetes and smoking at current were recorded. Results The levels of Hs-CRP and Hcy in acute myocardial infarction group and unstable angina pectoris group were obviously higher than those in the control group, while those of LDL and HDL were significantly lower than the control group. The levels of cystatin C and TC in acute my- ocardial infarction group were notably lower than those in the control group, and the level of cystatin C in unstable angina pectoris group significantly higher than that in the control group. There was no significant difference among each group. The history of diabetes, smoking and hypertension had effects on the level of Hcy, and no effects on the levels of Hs-CRP and cystatin C. Conclusion Variations of serum Hcy, Hs-CRP and eystatin C concentrations in ACS patients reflect the stability of artery atheromatous plaque to a certain extent.

关 键 词：急性冠脉综合征 粥样斑块 血清胱抑素C 同型半胱氨酸 急性时相C反应蛋白 

分 类 号：R541[医药卫生—心血管疾病]