sdLDL、FABP在冠心病诊断中的应用及Gensini评分的相关研究  

The Application of SdLDL,H-FABP in the Diagnosis of Coronary Artery Disease and the Related study of Gensini Score

作　　者：丁修冬[1] 薛凤凤[2] 沙立娜[3] 米运强[1] 付娆 张翼[1] DING Xiu-dong;XUE Feng-feng;SHA Li-na;MI Yun-qiang;FU Rao;ZHANG Yi(Department of Clinical Laboratory,Chinese PLA 309 Hospital,Beijing 100091,China;Chinese People＇s Liberation Army Nation Defense University Hospital,Beijing 100091,China;Weapon Industry Beijing North Hospital Beijing 100089,China;Hebei North University,Zhangjiakou 075000,China)

机构地区：[1]解放军第309医院检验科,北京100091 [2]国防大学医院,北京100091 [3]兵器工业北京北方医院,北京100089 [4]河北北方学院,河北张家口0750002

出　　处：《标记免疫分析与临床》2018年第9期1281-1285,共5页Labeled Immunoassays and Clinical Medicine

摘　　要：目的探讨小而密低密度脂蛋白(sdLDL)、心型脂肪酸结合蛋白(H-FABP)、同型半胱氨酸(HCY)、超敏C反应蛋白(hs-CRP)联合检测在冠心病诊断中的应用,以及sdLDL与冠状动脉血管病变严重程度的相关性。方法对2016年10月至2017年5月新入解放军第309医院急诊科、心内科经临床诊断确诊为冠心病的患者,跟踪留取其冠状动脉造影手术前后的血浆标本,同时留取健康查体者标本作为对照组,测定血浆sdLDL、H-FABP、HCY、LP(a)、hs-CRP、CHOL、TG、HDL-C及LDL-C的水平,将所有数据进行比对分析。结果冠心病组sdLDL、H-FABP、hs-CRP及LDL-C水平术前术后比较,差别有统计学意义(P <0. 05)。冠心病组术前的sdLDL、H-FABP、HCY、hs-CRP水平较对照组明显升高,差别有统计学意义(P<0. 05)。sdLDL水平在冠造阳性单支组与冠造阳性多支组组间比较差别有统计学意义(P <0. 05)。相关分析显示,sdLDL水平与Gensini评分呈正相关(r=0.477,<0. 01)。结论 sdLDL、H-FABP、HCY及hs-CRP升高均是发生冠心病的重要危险因素,可以为临床早期诊断冠心病提供参考依据,同时sdLDL、H-FABP、HCY、hs-CRP联合检测可以大大提高冠心病的诊断效率。相关分析显示,sdLDL水平对于预测冠状动脉血管病变严重程度有一定的指导意义。Objective To discuss the application of joint detection of the small dense low-density lipoprotein （sdLDL）, heart type fatty acid binding protein （H-FABP）, homocysteine （HCY）, high sensitive C reactive protein （hs-CRP） in diagnosis of coronary heart disease, and the correlation between sdLDL and the severity of coronary artery lesions. Methods From October, 2016 to May, 2017, patients who were enrolled in the People＇s Liberation Army 309 Hospital, including the Emergency Department and the Department of Cardiology and diagnosed （medical examination, laboratory, electrocardiogram, ultrasound, medical imaging） as coronary heart disease, were follow-up for the levels of plasma sdLDL, H-FABP, HCY, LP （a）, hs-CRP, CHOL, TG, HDL-C and LDL-C which were measured in the plasma samples before and after coronary angiography. All the data were then used for comparison analysis. Results The levels of sdLDL, H-FABP, hs-CRP and LDL-C in the patients with coronary heart disease were significantly higher than those before operation （P 〈 0.05）. The levels of sdLDL, H- FABP, HCY and hs- CRP in the patients with coronary heart disease were significantly higher than those in the control group （P 〈 0.05 ）. There was significant difference in the level of sdLDL between the single-branch positive group and the multi-branch positive group （P 〈 0.05 ）. Correlation analysis showed that sdLDL levels were positively correlated with Gensini scores （r = 0. 477, P 〈 0.01 ）. Conclusion sdLDL, H-FABP, HCY and hs-CRP are important risk factors for coronary heart disease, which can provide a reference for early diagnosis of coronary heartdisease. Meanwhile, efficiency of coronary predicting the severity sdLDL, H-FABP, HCY heart disease. Correlation of coronary artery disease and hs-CRP can be combined to improve the diagnostic analysis showed that sdLDL levels have significant values in predicting the severity of coronary artery disease.

关 键 词：小而密低密度脂蛋白 心型脂肪酸结合蛋白 冠状动脉粥样硬化性心脏病 GENSINI评分 

分 类 号：R541.4[医药卫生—心血管疾病]