血清胆红素与尿酸联合同型半胱氨酸检测对诊断冠心病的临床价值  

Clinical Value of Serum Bilirubin and Uric Acid Combined with Homocysteine in Diagnosis of Coronary Heart Disease

作　　者：张鹭坚 王腾腾 ZHANG Lujian;WANG Tengteng(Department of Clinical Laboratory,The First Affiliated Hospital of Xiamen University,School of Medicine,Xiamen University,Xiamen Key Laboratory of Gene Detection,Xiamen,Fujian 361000,China;Department of Clinical Laboratory,Xinglin District,The First Afliated Hospital of Xiamen University,Xiamen,Fujian 361022,China)

机构地区：[1]厦门大学附属第一医院检验科,厦门市基因检测重点实验室,福建厦门361000 [2]厦门大学附属第一医院杏林院区检验科,福建厦门361022

出　　处：《中国医药指南》2025年第6期81-84,共4页Guide of China Medicine

摘　　要：目的探讨在冠心病患者的诊断过程中采用血清胆红素、尿酸(UA)联合同型半胱氨酸(Hcy)联合检验的临床价值。方法选取2022年7月至2023年12月厦门大学附属第一医院收治的258例疑似冠心病患者,所有患者均需接受血清总胆红素(TBIL)、UA、Hcy检测与冠状动脉造影检查,将冠状动脉造影检查结果作为疾病诊断的金标准,对比单一TBIL、UA、Hcy检测与联合检测的诊断效能及在冠状动脉狭窄程度中的诊断准确率。结果金标准的检查结果显示,258例疑似患者中,有200例为阳性,有58例为阴性。在灵敏度、特异度、诊断准确率的比较上,TBIL、UA、Hcy联合检测均高于3项指标的单一检测(P<0.05)。金标准检查结果显示,确诊的200例患者中,轻度狭窄65例,中度狭窄55例,重度狭窄50例,完全闭塞30例。在轻度狭窄、中度狭窄、重度狭窄、完全闭塞诊断准确率的比较上,TBIL、UA、Hcy联合检测均高于3项指标的单一检测(P<0.05)。结论TBIL、UA、Hcy联合检测不仅能提高冠心病的诊断效能,还能进一步提升患者冠状动脉狭窄程度的诊断准确率。Objective To investigate the clinical value of serum bilirubin,uric acid(UA)combined with homocysteine(Hcy)test in the diagnosis of patients with coronary heart disease.Methods A total of 258 patients with suspected coronary heart disease admitted to the First Affiliated Hospital of Xiamen University from July 2022 to December 2023 were selected.All subjects were required to receive serum total bilirubin(TBIL),UA,Hcy detection and coronary angiography.The results of coronary angiography were taken as the gold standard for disease diagnosis.The diagnostic efficiency of single TBIL,UA,Hcy and combined detection and the diagnostic accuracy in the degree of coronary stenosis were compared.Results The gold standard examination results showed that of 258 suspected patients,200 were positive and 58 were negative.In the comparison of sensitivity,specificity and diagnostic accuracy,the combined detection of TBIL,UA and Hcy was higher than that of the single detection of the three indexes(P<0.05).Gold standard examination results showed that among the 200 patients diagnosed,65 cases were mild stenosis,55 cases were moderate stenosis,50 cases were severe stenosis,and 30 cases were complete occlusion.In the comparison of diagnostic accuracy of mild stenosis,moderate stenosis,severe stenosis and complete occlusion,the combined detection of TBIL,UA and Hcy was higher than that of the single detection of the three indexes(P<0.05).Conclusions The combined detection of TBIL,UA and Hcy can not only improve the diagnostic efficiency of coronary artery disease,but also further improve the diagnostic accuracy of coronary artery stenosis.

关 键 词：冠心病 血清总胆红素 尿酸 同型半胱氨酸 冠状动脉造影 冠状动脉狭窄程度 

分 类 号：R541.4[医药卫生—心血管疾病]