外周血指标联合检测对冠心病的诊断价值研究  

The value of joint detection of hypersensitive C-reactive protein,homocysteine and D-dimer in coronary heart disease

作　　者：曹敏晖[1] 谢琳[2] 尤倩[1] 谌芳[1] 彭飞[1] 吴意[1] 

机构地区：[1]湖南省人民医院检验科,长沙410005 [2]湖南省长沙血液中心,长沙410001

出　　处：《国际检验医学杂志》2017年第12期1611-1613,共3页International Journal of Laboratory Medicine

摘　　要：目的分析血清超敏C反应蛋白(hs-CRP)、同型半胱氨酸(Hcy)、D-二聚体水平与冠心病(CHD)的相关性,并探讨联合检测对冠心病诊断的诊断价值。方法收集100例冠心病患者(研究组)及100例无CHD的健康体检者(对照组),并依据合并症分为单纯CHD组(32例)、合并高血压组(46例)、合并糖尿病组(9例),合并高血压+糖尿病组(13例)、检测各组血清hsCRP、Hcy、D-二聚体水平,并进行统计学分析。结果研究组hs-CRP、Hcy、D-二聚体水平均显著高于对照组(P<0.05)。Logistic回归分显示,三项指标均为CHD的独立危险因素,对CHD诊治有一定的临床意义,以Hcy应用价值最高。两两联合检测中,hs-CRP和Hcy联合检测是较为理想的方案,三项联合检测不适于CHD的早期诊断。单纯CHD组、合并高血压组、合并高血压+糖尿病组hs-CRP、D-二聚体水平与合并糖尿病组比较差异有统计学意义(P<0.05)。结论 hs-CRP、Hcy、D-二聚体是CHD的独立危险因素,其联合检测对CHD的诊断效能较佳。Objective To analyze the correlation of hypersensitive C-reactive protein（hs-CRP） , homocysteineC H e y ） and D-dimer （D-D） with pathological change degree of coronary heart disease（CHD） ,and to investigate the diagnostic specificity and sensitivity of joint detection in CHD. Methods A total of 100 cases of CHD patients （ experimental group） and 100 healthy subjects （control group） were enrolled,. Patients of the experimental group were divided into four groups on the basis of complications, including simple CHD group（32 cases） , amalgamating hypertension group（46 cases）,amalgamating diabetes group（9 cases）,amalgamating hypertension diabetes group（13cases）. The levels of hs-CRP,Hcy and D-D in the five groups were detected and analyzed. Results The levels of hs-CRP？Hcy and D-D in the experimental group were all higher than the control group（P〈0. 05）. Logistic regression confirmed that three indexes were the independent risk factors for CHD. Each indicator has a certain clinical significance to the diag-nosis and treatment of CHD but the value of Hey could be better. Joint detection of hs-CRP and Hey could be an ideal combination of detection,and the three joint detection might not be suitable for early diagnosis and treatment of CHD. The levels of hs-CRP and D-D in simple CHD group, amalgamating hypertension group, amalgamating hypertension diabetes group were all higher than amal-gamating diabetes group（P〈0. 05）. Conclusion h s - C R P , Hey and D-D could be the independent risk factors of CHD,and joint de-tection might be with important clinical value for diagnosis of CHD.

关 键 词：冠心病 超敏C反应蛋白 同型半胱氨酸 D-二聚体 

分 类 号：R446.1[医药卫生—诊断学] R541.4[医药卫生—临床医学]