冠心病诊断中超敏C反应蛋白与血清同型半胱氨酸联合检查的意义评析  

Evaluation and analysis on significance of joint inspection of high-sensitivity C-reactive protein and serum homocysteine in diagnosis of coronary heart disease

作　　者：刘国连 黎霞[1] 陈宇锋[1] LIU Guo-lian LI Xia CHEN Yu-feng.(Department of Laboratory, Guangdong Province Maoming City People＇s Hospital, Maoming 525000, Chin)

机构地区：[1]广东省茂名市人民医院检验科,525000

出　　处：《中国实用医药》2017年第9期37-39,共3页China Practical Medicine

摘　　要：目的探索冠心病诊断中超敏C反应蛋白(hs-CRP)与血清同型半胱氨酸(HCY)联合检查的临床价值。方法 120例疑似冠心病患者作为观察组(不稳定型心绞痛、心肌梗死、稳定型心绞痛各40例),40例健康体检者作为对照组,对所有研究对象进行hs-CRP与血清HCY联合检查。结果观察组稳定型心绞痛患者的HCY为(12.58±4.25)μmol/L,B型脑钠肽(BNP)为(186.25±85.36)pg/ml,hsCRP为(1.68±0.89)ng/ml,肌红蛋白为(124.36±36.47)ng/ml,肌钙蛋白为(0.74±0.95)ng/ml;心肌梗死患者的HCY为(13.98±4.74)μmol/L,BNP为(451.36±89.36)pg/ml,hs-CRP为(1.75±1.27)ng/ml,肌红蛋白为(154.25±38.61)ng/ml,肌钙蛋白为(1.65±0.47)ng/ml;不稳定型心绞痛患者的HCY为(15.96±5.18)μmol/L,BNP为(765.36±105.69)pg/ml,hs-CRP为(1.87±1.47)ng/ml,肌红蛋白为(174.85±42.95)ng/ml,肌钙蛋白为(1.78±1.42)ng/ml,观察组各种患者各指标数据均高于对照组的(9.56±2.47)μmol/L、(59.36±30.47)pg/ml、(0.21±0.05)ng/ml、(86.31±24.05)ng/ml、(0.31±0.14)ng/ml,差异有统计学意义(P<0.05)。hs-CRP联合血清HCY在冠心病患者中灵敏性、特异性、漏诊率、误诊率分别为98.00%、95.00%、2.00%、5.00%,均优于hs-CRP检测的72.00%、50.00%、28.00%、50.00%和血清HCY检测的73.00%、45.00%、27.00%、55.00%,差异有统计学意义(P<0.05)。联合诊断和确诊结果比较,差异无统计学意义(P>0.05)。结论 hs-CRP联合血清HCY在冠心病患者中具有较高的诊断价值。Objective To explore clinical value of joint inspection of high-sensitivity C-reactive protein（hs-CRP） and serum homocysteine（HCY） in diagnosis of coronary heart disease. Methods There were 120 suspected coronary artery disease patients as observation group（with 40 cases in unstable angina pectoris, myocardial infarction and stable angina pectoris）, and 40 health examination people as control group. All study subjects received joint inspection of hs-CRP and serum HCY. Results Stable angina pectoris patients in observation group had HCY as（12.58±4.25） μmol/L, B-type natriuretic peptide（BNP） as（186.25±85.36） pg/ml, hs-CRP as（1.68±0.89） ng/ml, myohemoglobin as（124.36±36.47） ng/ml, troponin as（0.74±0.95） ng/ml. Myocardial infarction patients had HCY as（13.98±4.74） μmol/L, BNP as（451.36±89.36） pg/ml, hs-CRP as（1.75±1.27） ng/ml, myohemoglobin as（154.25±38.61） ng/ml, troponin as（1.65±0.47） ng/ml. Unstable angina pectoris patients had HCY as（15.96±5.18） μmol/L, BNP as（765.36±105.69） pg/ml, hs-CRP as（1.87±1.47） ng/ml, myohemoglobin as（174.85±42.95） ng/ml, troponin as（1.78±1.42） ng/ml. All were higher than（9.56±2.47） μmol/L,（59.36±30.47） pg/ml,（0.21±0.05） ng/ml,（86.31±24.05） ng/ml and（0.31±0.14） ng/ml in control group, and their differences had statistical significance（P〈0.05）. Coronary heart disease patients had sensitivity, specificity, missed diagnosis rate and misdiagnosis rate by joint detection of hs-CRP and serum HCY respectively as 98.00%, 95.00%, 2.00% and 5.00%, which were all better than 72.00%, 50.00%, 28.00% and 50.00% by hs-CRP detection and 73.00%, 45.00%, 27.00% and 55.00% by serum HCY detection. Their differences had statistical significance（P〈0.05）. There were no statistically significant difference between joint detection and confirmed outcome（P〉0.05）. Conclusion Joint detection of hs-CRP and serum HCY shows high diagnostic value in choronary heart disease patients.

关 键 词：冠心病 超敏C反应蛋白 血清同型半胱氨酸 诊断 

分 类 号：R541.4[医药卫生—心血管疾病] R446.1[医药卫生—内科学]