hsCRP、HCY水平对老年冠心病患者的诊断价值  

Diagnostic value of hsCRP and HCY levels in gerontal patients with coronary heart disease

作　　者：张军 

机构地区：[1]山东省巨野县人民医院心内一科,巨野274900

出　　处：《中国循证心血管医学杂志》2014年第4期474-477,共4页Chinese Journal of Evidence-Based Cardiovascular Medicine

摘　　要：目的探讨高敏C反应蛋白(hsCRP)、同型半胱氨酸(HCY)水平在单、多支冠状动脉病变的老年冠心病患者中的诊断价值。方法选取老年冠状动脉病变患者120例,根据冠状动脉病变支数不同分为单支组(n=47)、双支组(n=41)、多支组(n=32),另选取同期体检健康者40例作为对照组。采用全自动生化分析仪和免疫比浊法分别测定一般临床指标及hsCRP、HCY水平,采用ROC曲线判断hsCRP、HCY诊断冠状动脉病变支数的截点及相应的敏感性和特异性。结果与对照组比较,单支组、双支组、多支组患者血清hsCRP、HCY水平增高,有统计学差异(P<0.05);与单支组比较,双支组患者HCY水平增高,多支组患者hsCRP、HCY水平增高,有统计学差异(P<0.05);与双支组比较,多支组患者hsCRP水平增高,有统计学差异(P<0.05)。以hsCRP>9.6 mmol/L为标准诊断单支组的敏感性为62.51%、特异性为87.42%、准确性为79.85%;诊断双支组的敏感性为66.78%、特异性为90.17%、准确性为85.64%;诊断多支组的敏感性为80.46%、特异性为96.35%、准确性为89.47%。以HCY>7.3 mmol/L为标准诊断单支组的敏感性为55.75%、特异性为80.63%、准确性为65.58%;诊断双支组的敏感性为63.58%、特异性为86.17%、准确性为76.84%;诊断多支组的敏感性为73.75%、特异性为91.38%、准确性为82.66%。结论 hsCRP、HCY水平在单、双、多支老年患者冠状动脉病变中的诊断有较高的敏感性和特异性。Objective To investigate the diagnostic value of high-sensitivity C-reactive protein （hsCRP） and homocysteine （HCY） levels in gerontal patients with single or multiple vessel lesion of coronary heart disease （CHD）. Methods The patients （n=120） were divided into 1-vessel group （n=47）, 2-vessel group （n=41） and multi-vessel group （n=32） according to the number of diseased coronary vessels, and other health persons （n=40） were chosen as control group. The general indexes and levels of hsCRP and HCY were detected by using automatic biochemical analyzer and immunoturbidimetry respectively. The cut-point, sensitivity and specificity of hsCRP and HCY in diagnosis of number of diseased coronary vessels were judged by using ROC curve. Results Compared with control group, hsCRP and HCY increased in other 3 groups （P〈0.05）. Compared with 1-vessel group, HCY increased in 2-vessel group and hsCRP and HCY increased in multi-vessel group （P〈0.05）. Compared with 2-vessel group, hsCRP increased in multi-vessel group （P〈0.05）. Taking hsCRP〉9.6 mmol/L as the standard, the diagnostic sensitivity was 62.51%, specificity was 87.42%and accuracy was 79.85%in 1-vessel group, 66.78%, 90.17%and 85.64%in 2-vessel group, and 80.46%, 96.35%and 89.47%in multi-vessel group. Taking HCY〉7.3 mmol/L as the standard, the diagnostic sensitivity was 55.75%, specificity was 80.63%and accuracy was 65.58%in 1-vessel group, 63.58%, 86.17%and 76.84%in 2-vessel group, and 73.75%, 91.38%and 82.66%in multi-vessel group. Conclusion The levels of hsCRP and HCY have higher sensitivity and specificity in the diagnosis of single or multiple vessel lesion of CHD in gerontal patients.

关 键 词：高敏C反应蛋白 冠状动脉病变 老年患者 单支病变 多支病变 诊断价值 

分 类 号：R541.4[医药卫生—心血管疾病]