老年冠状动脉粥样硬化性心脏病患者TBIL、HCY、Hs-CRP、UA水平与冠状动脉不稳定性斑块形成风险的关系  

Relationship between the levels of TBIL,Hcy,hs CRP,UA and the risk of unstable plaque formation in elderly patients with coronary heart disease

作　　者：蒋薇 闵祖良 刘杰杰 陈锡创 JIANG Wei;MIN Zuliang;LIU Jiejie;CHEN Xichuang(Department of Emergency Medicine,Wuxi Ninth People's Hospital,Wuxi Jiangsu 214000,China)

机构地区：[1]无锡市第九人民医院急诊科,江苏无锡214000 [2]无锡市第九人民医院心内科,江苏无锡214000 [3]无锡市第九人民医院药剂科,江苏无锡214000

出　　处：《中国急救复苏与灾害医学杂志》2022年第3期304-308,共5页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：2016年无锡市科技发展指导性计划项目(编号:CSN0N1624)。

摘　　要：目的探讨老年冠状动脉粥样硬化性心脏病(简称“冠心病”)患者总胆红素(TBIL)、同型半胱氨酸(HCY)、超敏C反应蛋白(Hs-CRP)、尿酸(UA)水平与冠状动脉不稳定性斑块形成风险的关系。方法选取无锡市第九人民医院冠心病患者186例,根据颈动脉多普勒超声检测斑块回声特征分为冠状动脉不稳定性斑块组51例,无冠状动脉不稳定性斑块组135例。对比两组患者基础资料[年龄、性别、身体质量指数(BMI)、心率(HR)、肱动脉收缩压(SBP)、舒张压(DBP)、高血压史、糖尿病史、吸烟史]及实验室检查结果[总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、TBIL、HCY、Hs-CRP、UA],绘制ROC曲线分析血清TBIL、HCY、Hs-CRP、UA水平对老年冠心病患者冠状动脉不稳定性斑块形成的预测价值,将有差异信息纳入多因素Logistic回归分析,行量化赋值,通过Logistic回归性分析明确老年冠心病患者冠状动脉不稳定性斑块形成的危险因素。结果两组年龄、性别、BMI、HR、SBP、DBP、高血压史、糖尿病史、吸烟史、TC、TG、LDL-C、HDL-C比较无显著差异(P>0.05),冠状动脉不稳定性斑块组血清TBIL水平显著低于无冠状动脉不稳定性斑块组,血清HCY、Hs-CRP、UA水平显著高于无冠状动脉不稳定性斑块组(P<0.05)。经ROC分析血清TBIL、HCY、Hs-CRP、UA水平的曲线下面积分别为0.718、0.825、0.832、0.768。经Logistic回归性分析证实血清TBIL≤10.700、HCY>14.810、Hs-CRP>2.630、UA>337.990是老年冠心病患者冠状动脉不稳定性斑块形成的危险因素。结论血清TBIL、HCY、Hs-CRP、UA水平是预测老年冠心病患者冠状动脉斑块不稳定性形成的可行性指标,测定这些指标可以为临床评估患者病情严重程度提供参考。Objective To investigate the relationship between the levels of total bilubin(TBIL),homocysteine(Hcy),high sensitivity C reactive protein(hs CRP),uric acid(UA)and the risk of plaque formation in coronary artery instability.Methods 186 patients with coronary heart disease in Wuxi Ninth People's hospital were selected.According to the echo characteristics of carotid Doppler ultrasound,51 patients were divided into the group of unstable coronary artery plaque and 135 cases without unstable coronary artery plaque.The basic data[age,gender,body mass index(BMI),heart rate(HR),systolic blood pressure(SBP),diastolic blood pressure(DBP),history of hypertension,diabetes,smoking]and laboratory examination results[total cholesterol,TC,triglyceride,TG,high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),TBIL,Hcy,hs CRP,UA],ROC curve was drawn to analyze the predictive value of serum TBIL,Hcy,hs-CRP and UA levels on the formation of unstable plaque.Logistic regression analysis was used to identify the risk factors of unstable plaque formation.Results There was no significant difference in age,gender,BMI,HR,SBP,DBP,hypertension history,diabetes history,smoking history,TC,TG,LDL-C,HDL-C between the two groups(all P>0.05),The levels of serum TBIL,Hcy,hs-CRP and UA in the unstable plaque group were all significantly lower than those in the non-unstable plaque group(all P<0.05).ROC analysis showed that the areas under the curve of serum TBIL,Hcy,hs-CRP and UA levels were 0.718,0.825,0.832 and 0.768 respectively.Logistic regression analysis confirmed that sex rum TBIL≤10.700μmol/L,Hcy>14.810 umol/L,hs-CRP>2.630 mg/L,and UA>337.990μmol/L were all risk factors of unstable plaque formation in elderly patients with coronary heart disease.Conclusion Serum levels of TBIL,Hey,hs-CRP and UA are feasible indicators to predict the formation of coronary plaque instability in the elderly CHD patients.Measurement of these indicators helps provide reference for elinical evaluation of the severity of the disea

关 键 词：老年 冠心病 尿酸 冠状动脉不稳定性斑块 风险 

分 类 号：R196.7[医药卫生—卫生事业管理]