血清胱抑素C水平与冠心病相关性研究  

Relationship between serum cystatin C jevel and coronary heart disease

作　　者：刘玉薇 冯晓敏 苏静静 万楠[2] LIU Yuwei;FENG Xiaomin;SU Jingjing;WAN Nan(Postgraduate Training Base,the General Hospital of Shenyang Military Region Dalian,Medical University,Dalian,Liaoning 116044,China;Laboratory of The General Hospital of Shenyang,Military,Shenyang,Liaoning 110016,China)

机构地区：[1]大连医科大学沈阳军区总医院研究生培养基地,辽宁大连116044 [2]沈阳军区总医院检验科,辽宁沈阳110016

出　　处：《国际检验医学杂志》2019年第1期52-55,共4页International Journal of Laboratory Medicine

基　　金：辽宁省科学技术基金资助项目(201602792)

摘　　要：目的探究血清胱抑素C(Cys C)水平与冠状动脉粥样硬化性心脏病(下称冠心病)的诊断及冠状动脉(冠脉)病变程度的相关性。方法选取340例沈阳军区总医院心血管内科收治的接受冠脉造影术的患者作为研究对象,分为非冠心病组即冠脉粥样硬化组(37例)和冠心病组(303例),冠心病组患者中心绞痛134例,急性非ST段抬高型心肌梗死82例,急性ST段抬高型心肌梗死87例。检测两组患者入院时及冠脉造影术或经皮冠脉介入(PCI)治疗后第2天血清Cys C水平,分析Cys C水平与冠心病的诊断及与冠脉病变程度的相关性。结果 (1)冠心病患者Cys C水平[(0.72±0.22)mg/L]明显高于非冠心病患者[(0.56±0.07)mg/L],差异有统计学意义(P<0.05);血清Cys C水平诊断冠心病的受试者工作特征曲线下面积为0.784,特异度与灵敏度分别为70.32%和78.38%;不同冠脉病变患者Cys C水平比较,差异无统计学意义(P>0.05)。(2)单支血管病变冠心病患者Cys C水平[(0.63±0.21)mg/L]显著低于双支和多支病变者[分别为(0.72±0.22)、(0.75±0.21)mg/L],差异均有统计学意义(P<0.05),且Cys C水平与病变血管数呈显著正相关(r=0.269,P<0.05)。(3)接受PCI的患者术后Cys C水平升高,只接受冠脉造影患者Cys C水平无明显变化。结论 Cys C作为冠心病的诊断指标尚显不足,但与冠脉病变程度密切相关,且可能与PCI术后炎性反应有关,可用于辅助评估病情及术后检测。Objective To investigate the correlation between serum cystatin C(Cys C)and the diagnosis of coronary heart disease and coronary artery stenosis degree.Methods A total of 340 patients with coronary angiography were enrolled in this study.They were divided into non-coronary heart disease group(37 cases)and coronary heart disease group(303 cases).Coronary heart disease group includes 134 patients with angina pectoris,82 patients with acute non-ST elevation myocardial infarction,87 patients with acute ST segment elevation myocardial infarction.Detection of serum Cys C levels at admission and on the second day after coronary angiography or percutaneous coronary intervention(PCI),and the relationship between Cys C and the diagnosis of coronary heart disease and coronary artery stenosis degree were analyzed statistically.Results The Cys C level in patients with coronary heart disease(0.72±0.22)mg/L was significantly higher than that in non-coronary heart disease patients[(0.56±0.07)mg/L,P<0.05].Area under ROC curve was 0.784 in diagnosis of coronary heart disease by serum Cys C,which showed specificity and sensitivity in diagnosis respectively as 70.32%and 78.38%.There was no significant difference in Cys C levels between the groups with coronary heart disease.Cys C levels in single-vessel disease(0.63±0.21)mg/L were significantly lower than those in bi-and multi-vessel disease[(0.72±0.22)mg/L,(0.75±0.21)mg/L,P<0.05],and the Cys C level was positively correlated with the number of lesions,and the correlation coefficient was 0.227,P<0.05.Cys C levels were elevated in patients with percutaneous coronary intervention,but there was no significant change in patients with coronary angiography alone.Conclusion Cys C is still insufficient as a diagnostic indicator of coronary heart disease,but it is closely related to the severity of coronary artery disease,and may be related to inflammatory reaction after PCI.It can be used to assist in assessing the condition and postoperative detection.

关 键 词：冠心病 抑素类 血管成形术 经腔 经皮冠状动脉 支架 实验室技术和方法 

分 类 号：R541.4[医药卫生—心血管疾病] R446.112[医药卫生—内科学]