血清淀粉样蛋白A与冠心病的相关性研究  

Correlation between serum amyloid A and coronary heart disease

作　　者：张璐璐[1] 刘芸[1] 段文冰[1] 唐闻[1] 李晓莹[1] 赵万辉[1] 许瑞[1] Zhang Lulu;Liu Yun;Duan Wenbing;Tang Wen;Li Xiaoying;Zhao Wanhui;Xu Rui(Department of Clinical Laboratory,Shandong Provincial Hospital Affiliated to Shandong University,Ji’nan 250021,China)

机构地区：[1]山东大学附属省立医院临床医学检验部,济南250021

出　　处：《新医学》2019年第1期11-15,共5页Journal of New Medicine

基　　金：山东省自然科学基金(ZR2014HP043);山东省科学技术发展计划(2014GGH218041);山东省临床重点专科建设项目(鲁卫医字[2013]26号)

摘　　要：目的探讨血清淀粉样蛋白A(SAA)与冠状动脉粥样硬化性心脏病(冠心病,CHD)患者的诊断、病变程度及预后的相关性。方法收集CHD患者共118例,包括46例AMI患者(AMI组)、38例不稳定性心绞痛患者(UA组)、34例稳定性心绞痛患者(SA组)以及30例正常对照者(正常对照组),分别检测4组患者的SAA、CRP、降钙素原、IL-6、高敏肌钙蛋白T(hs-TnT)、CK-MB、肌红蛋白、血清脑钠肽前体(NT-ProBNP)水平及CHD组的HDL-C、LDL-C、总胆固醇、甘油三酯和脂蛋白a;采用Pearson法分析SAA同上述指标及CHD危险因素和Gensini评分的相关性。结果①CHD组的SAA、IL-6、降钙素原的水平高于正常对照组(P<0.05),并且呈现AMI组>UA组>SA组的趋势,且在冠状动脉单支病变、双支病变、多支病变者逐渐增高。CRP在AMI组的水平高于正常对照组(P <0.05),但在其它任意2组间差异无统计学意义(P均> 0.05)。②AMI组、UA组的hs-TnT、NT-ProBNP、CK-MB、肌红蛋白的水平高于正常对照组及SA组(P均<0.05),呈现AMI组>UA组>SA组的趋势,而在SA组与正常对照组间差异无统计学意义;在冠状动脉病变程度上也无明显差异(P> 0.05)。③SAA与IL-6、降钙素原、CRP、甘油三酯的水平呈正相关,与LDL-C水平呈负相关,与Gensini评分在AMI组及UA组呈正相关,而在SA组无相关性。结论 SAA对于CHD的临床辅助识别的敏感性较高,对筛查高危人群、CHD病情的观察及判断其预后有一定的临床意义。Objective To investigate the correlation between the serum amyloid A(SAA) and the diagnosis, severity and prognosis of patients with coronary heart disease(CHD). Methods A total of 118 CHD patients were recruited in this study, including forty-six cases of acute myocardial infarction(AMI), 38 patients diagnosed with unstable angina pectoris(UA), 34 cases of stable angina pectoris(SA). 30 healthy people were as normal controls. The SAA, C-reactive protein(CRP), calcitonin(PCT), interleukin 6(IL-6), hs-TnT(cardiac troponin T), CK-MB(creatine kinase), MYO(myoglobin), NT-ProBNP(B-type natriuretic) of patients in four groups and the high density lipoprotein cholesterol(HDL-C), low density lipoprotein cholesterol(LDL-C), total cholesterin(CHO), triglyceride(TG), lipoprotein a(LPa) of patients in the CHD group were quantitatively detected. The correlation between the SAA and the above indexes, risk factors of coronary heart disease and Gensini scores were analyzed by Pearson’s correlation analysis. Results The levels of SAA, IL-6 and PCT in patients with CHD were significantly higher than those in the control group(all P < 0.05), and showed a trend of AMI>UA>SA, and increased in the patients with coronary artery disease alone, coronary artery double branch disease and multiple coronary artery disease. The CRP level in the AMI group was significantly higher than that in the normal control group(P < 0.05), but there was no significant difference between the other two groups(P > 0.05). The levels of hs-TnT, NT-ProBNP, CK-MB and MYO in the patients with AMI and UA were significantly higher compared with those in the normal control and SA groups(all P < 0.05), showing the trend of AMI>UA>SA, but there was no statistical difference between the SA and normal control groups. No statistical significance was noted in the degree of coronary artery disease(P > 0.05). SAA was positively correlated with the levels of IL-6, PCT, CRP and TG, whereas negatively correlated with the LDL-C level. There was a positive correlation with the

关 键 词：血清淀粉样蛋白A 冠状动脉粥样硬化性心脏病 急性心肌梗死 

分 类 号：R541.4[医药卫生—心血管疾病]