三种血清指标联合检测对冠心病患者冠状动脉狭窄程度诊断的应用价值分析  

Value of combined detection of three serum indicators in diagnosis of coronary artery stenosis in patients with coronary heart disease

作　　者：凌莉萍 黄晓昳 Ling Liping;Huang Xiaoyi(Department of Clinical laboratory,Linping Hospital of Traditional Chinese Medicine,Hangzhou 311106,Zhejiang Province China)

机构地区：[1]杭州市临平区中医院检验科,311106

出　　处：《中华老年心脑血管病杂志》2023年第7期712-715,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

摘　　要：目的探讨血清载脂蛋白、红细胞分布宽度(RDW)及S腺苷同型半胱氨酸(SAH)联合检测对冠心病患者冠状动脉狭窄程度诊断的应用价值。方法选取2020年1月至2022年2月在杭州市临平区中医院于心内科就诊的冠心病患者121例,并根据患者冠状动脉狭窄程度将其分为轻度狭窄组26例(Gensini评分<20分)、中度狭窄组52例(Gensini评分20~50分)和重度狭窄组43例(Gensini评分>50分),比较各组冠心病患者血清载脂蛋白A(apoA)、载脂蛋白B(apoB)、apoB/apoA、RDW、SAH水平差异,采用ROC曲线下面积(AUC)分析各指标及联合检测对冠心病的诊断价值。结果重度狭窄组apoB、apoB/apoA、RDW、SAH水平明显高于轻度狭窄组和中度狭窄组(P<0.05),中度狭窄组apoB、apoB/apoA、RDW、SAH水平明显高于轻度狭窄组(P<0.05)。apoB/apoA、RDW、SAH水平与冠状动脉狭窄程度呈正相关(r=0.726,r=0.659,r=0.615,P<0.01)。apoB/apoA、RDW、SAH三者联合诊断冠状动脉狭窄程度的ROC曲线下面积为0.975(95%CI:0.950~0.999,P<0.01)。结论apoB/apoA、RDW、SAH水平与冠状动脉狭窄程度呈正相关,且上述三种血清因子联合检测对冠心病患者冠状动脉狭窄程度的诊断具有重要参考价值。Objective To investigate the diagnostic value of apolipoprotein(apo),red blood cell distribution width(RDW)and S-adenosine homocysteine(SAH)for coronary artery stenosis in patients with coronary heart disease(CHD).Methods A total of 121 CHD patients admitted in the cardiological department of our hospital from January 2020 to February 2022 were enrolled,and divided into mild(Gensini score<20,26 cases),moderate(20-50,52 cases)and severe stenosis(>50,43 cases)groups according to the severity of stenosis.The levels of apoA and apoB,ratio of apoB/A,RDW and SAH level were compared in the 3 groups,and diagnostic values of these indicators single or combined together for CHD were evaluated with the area under the ROC curve(AUC).Results apoB,apoB/apoA,RDW and SAH were significantly higher in the severe stenosis group than the mild and moderate stenosis groups(P<0.05),and were obviously higher in the moderate stenosis group than the mild stenosis group(P<0.05).apoB/apoA,RDW and SAH were positively correlated with the severity of coronary artery stenosis(r=0.726,r=0.659,r=0.615,P<0.01).The AUC value of combined detection of the 3 indicators was 0.975(95%CI:0.950-0.999,P<0.01)in diagnosis of coronary artery stenosis.Conclusion apoB/apoA,RDW and SAH are positively correlated with coronary artery stenosis.Moreover,the combined detec-tion of them has important reference value for the diagnosis of coronary artery stenosis in CHD patients.

关 键 词：冠心病 冠状动脉狭窄 载脂蛋白类 高半胱氨酸 

分 类 号：R541.4[医药卫生—心血管疾病]