世居高原人群血清胱抑素-C以及C反应蛋白浓度与冠状动脉慢血流现象的关系  

Relationship between serum concentrations of C reactive protein and cystatin C with coronary slow flow phenomenon in the native of high altitude area

作　　者：邓勇 马晓峰 王红 徐境苹 汪鲁青 

机构地区：[1]青海省心脑血管病专科医院干部保健科,青海西宁810012

出　　处：《岭南心血管病杂志》2017年第5期530-533,546,共5页South China Journal of Cardiovascular Diseases

基　　金：青海省卫生计生科研课题(项目编号:2016-wjqn-05)

摘　　要：目的探讨比较世居高原人群血清胱抑素-C(cystatin C,Cys-C)、C-反应蛋白(C-reactive protein,CRP)浓度与冠状动脉慢血流现象(coronary slow flow phenomenon,CSFP)的相关性。方法入选2014年6月至2016年1月因胸痛并疑似冠状动脉粥样硬化性心脏病(冠心病)于青海省心脑血管病专科医院行冠状动脉造影检查,结果显示冠状动脉无明显狭窄且存在CSFP的患者134例为慢血流组,并随机选取同期行冠状动脉造影提示冠状动脉无明显狭窄且血流正常的患者136例为对照组。采用校正的心肌梗死溶栓试验(thrombolysis inmyocardial infarction,TIMI)血流计帧法(corrected TIMI frame count,CTFC)检测,其中CTFC值>27诊断为冠状动脉慢血流。检测并记录相关临床资料进行统计分析。结果两组间年龄比较,差异无统计学意义(P>0.05);两组性别、吸烟史、原发性高血压(高血压)病史、糖尿病史比较,差异均有统计学意义(P<0.05);慢血流组白细胞计数、血小板计数、血浆纤维蛋白原、空腹血糖、糖化血红蛋白、果糖胺、总胆固醇、脂蛋白(a)、血管紧张素转化酶与对照组比较,差异均无统计学意义(P>0.05);两组红细胞计数、血红蛋白浓度、红细胞比容、CRP、Cys-C、同型半胱氨酸、尿酸、三酰甘油、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇比较,差异均有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,吸烟、糖尿病、高血压、红细胞计数、血红蛋白浓度、低密度脂蛋白胆固醇、Cys-C、CRP、尿酸、同型半胱氨酸是冠状动脉慢血流的危险因素(P<0.05);而高密度脂蛋白胆固醇是冠状动脉慢血流的保护因素(P<0.05)。结论血清Cys-C、CRP浓度与高原地区患者CSFP的发生明确相关,可作为临床预测高原地区CSFP发生的危险因素。Objectives To study and compare the correlation of serum concentrations of cystatin C（Cys）,C-reactive protein（CRP）with coronary slow flow phenomenon（CSFP）in the native of high altitude area. Methods Patients be-cause of chest pain and suspected coronary heart disease for coronary angiography were selected from June 2014 to Janu-ary 2016 in Cardiovascular and Cerebrovascular Disease Hospital of Qinghai Province. The results showed that coronary artery without significant stenosis and CSFP in 134 patients（slow blood flow group）. At the same period ,136 patients with coronary artery without significant stenosis and normal blood flow were in control group. Corrected thrombolysis in myocardial infarction（TIMI）frame count（CTFC）was used to detect coronary slow flow. CTFC value 〉27 was diag-nosed as coronary slow flow. Related clinical data were detected and recorded for statistical analysis. Results There was no significant difference in age between the two groups（P〉0.05）. Differences of percentages of patients with gen-der,smoking history,history of hypertension,history of diabetes were statistically significant between the two groups （P〈0.05）. White blood cell count （WBC）,platelet count （PLT）,plasma fibrinogen （Fib）,fasting blood glucose （FPG）,glycosylated hemoglobin（HbA1c）,fructosamine（FMN）,total cholesterol（TC）,lipoprotein（a）[LP（a）],angiotensin converting enzyme（ACE）of slow blood flow group showed no significant differences with those of control group（P〉0.05）. Differences of red blood cell count（RBC）,hemoglobin（HGB）,hematocrit（HCT）,CRP,Cys-C, homocysteine（Hcy）,uric acid（UA）,triacylglycerol（TG）,low density lipoprotein-cholesterol（LDL-C）,high den-sity lipoprotein-cholesterol（HDL-C）between slow blood flow group and control group were statistically significant dif-ference （P〈0.05）. Multivariate Logistic regression analysis showed that smoking,diabetes,hypertension,RBC, HGB,LDL-C,Cys-C,CRP,UA,Hcy were

关 键 词：冠状动脉疾病 高原地区 慢血流 血清胱抑素-C C-反应蛋白 

分 类 号：R541.4[医药卫生—心血管疾病]