肾功能正常的冠心病患者中血清胱抑素C水平及与其他指标的相关性  

Serum cystatin C level in coronary heart disease patients with normal renal function and its clinical significance

作　　者：蔡红莉[1] 陈佳漪[1] 顾言[1] 单益梅[1] 陆尽亚[1] 黎叶飞[2] 张清[2] CAI Hong-li;CHEN Jia-yi;GU Yan;SHAN Yi-mei;LU Jin-ya;LI Ye-fei;ZHANG Qing(Geriatric department,Nantong First People＇s Hospital,Nantong,Jiangsu 226001,China)

机构地区：[1]南通市第一人民医院老年科,江苏南通226001 [2]南通市第一人民医院心内科,江苏南通226001

出　　处：《中国临床研究》2018年第8期1051-1053,共3页Chinese Journal of Clinical Research

摘　　要：目的通过分析血清胱抑素C(Cys-C)在肾功能正常的冠心病患者中的水平,为冠心病的预防及危险度分层提供参考。方法选取2016年9月至2017年9月在南通市第一人民医院住院的肾功能正常的冠心病患者100例,分为稳定型心绞痛组(SAP组,n=38)和急性冠脉综合征组(ACS组,n=62);以同期胸痛或胸闷症状入院的非冠心病患者50例为对照组。采用胶乳增强免疫比浊法测定Cys-C水平,比较分析各组Cys-C水平的差异及不良事件发生情况和预后。结果对照组、SAP组、ACS组血清Cys-C值分别为(1.6±0.7)mg/L、(2.1±0.8)mg/L、(2.8±0.9)mg/L,ACS组显著高于对照组和SAP组(P<0.01),SAP组显著高于对照组(P<0.01)。以Cys-C中位数1.71 mg/L为界,分为低Cys-C组和高Cys-C组。高Cys-C组新发心力衰竭、恶性心律失常以及不良事件的总发生率均高于低Cys-C组(P<0.05,P<0.01)。结论冠心病组患者外周血Cys-C水平增高,其中ACS组高于SAP组,Cys-C的表达越高其不良事件的发生率越高且预后越差,Cys-C可在冠心病的诊断评估及危险度分层中起着重要作用,可作为重要的参考指标之一。Objective To analyze serum cystatin C（Cys-C） level in coronary heart disease patients with normal renal function in order to provide reference for coronary heart disease prevention and risk stratification. Methods A total of 100 coronary heart disease patients with normal renal function admitted in Nantong First People＇s Hospital from September 2016 to September 2017 were selected. The patients were divided into stable angina pectoris group（group SAP,n = 38） and acute coronary syndrome group（group ACS,n = 62）. A total of 50 non-coronary heart disease patients with chest pain or chest distress admitted in the same period were selected as control group. Turbidimetric inhibition immuno assay was used to detect Cys-C level. The difference of serum Cys-C level,adverse events and prognosis were compared among three groups. Methods Serum Cys-C level in ACS group was significantly higher than those in control group[（2. 8 ± 0. 9） mg/L vs（1. 6 ± 0. 7） mg/L,P〈0. 01]and SAP groups [（2. 8 ± 0. 9） mg/L vs（2. 1 ± 0. 8） mg/L,P〈0. 01]. With the Cys-C median 1. 71 mg/L as the boundary,the coronary heart disease patients were divided into low Cys-C group and high Cys-C group. The refractory angina pectoris,heart failure of new occurrence,malignant arrhythmia and total incidence of adverse events in high Cys-C group were significantly higher than those in low Cys-C group（P〈0. 05,P〈0. 01）. Conclusions Cys-C level in peripheral blood increases in coronary heart disease patients especially the ACS patients. The higher the level of Cys-C level,the higher the incidence of adverse events and the worse prognosis. Cys-C plays an important role in diagnosis of coronary heart disease and risk stratification of coronary heart disease,and it can serve as one of the reference indexes.

关 键 词：血清胱抑素C 冠心病 稳定型心绞痛 急性冠脉综合征 不良心血管事件 

分 类 号：R541.4[医药卫生—心血管疾病]