血清hs-CRP、Hcy、D-D联合检测在冠心病预后评估中的应用价值  

The Application Value of Combined Detection of Serum Hs-CRP,Hcy,and D-D in the Prognosis Evaluation of Coronary Heart Disease

作　　者：杨文贞 何雯 王延伟[1] YANG Wenzhen;HE Wen;WANG Yanwei(Department of Laboratory,Jining Municipal Government Hospital,Jining 272000,Shandong,China;Department of Thyroid Surgery,Affiliated Hospital of Jining Medical University,Jining 272000,Shandong,China)

机构地区：[1]济宁市市直机关医院检验科,山东济宁272000 [2]济宁医学院附属医院甲状腺外科,山东济宁272000

出　　处：《系统医学》2025年第5期8-11,共4页Systems Medicine

摘　　要：目的探究血清超敏C反应蛋白(hypersensitive C-reactive protein,hs-CRP)、同型半胱氨酸(homocysteine,Hcy)、D-二聚体(D-Dimer,D-D)联合检测对冠状动脉粥样硬化性心脏病(coronary heart disease,CHD)预后的预测价值。方法回顾性选取济宁市市直机关医院于2020年1月—2022年12月收治的89例CHD患者的临床资料,均随访1年,依据随访期间是否出现心脏不良事件分为预后不良组(n=33)和预后良好组(n=56)。对比两组血清hs-CRP、Hcy、D-D水平;分析CHD预后不良影响因素;绘制ROC曲线分析血清hs-CRP、Hcy、D-D单项及联合检测CHD的预测价值。结果预后不良组血清hs-CRP、Hcy、D-D水平均高于预后良好组,差异有统计学意义(P均<0.05)。血清hs-CRP(OR=1.956,95%CI=1.709~2.239)、Hcy(OR=2.123,95%CI=1.808~2.494)、D-D(OR=2.217,95%CI=1.917~2.563)均为CHD预后不良的独立危险因素。血清hs-CRP、Hcy、D-D联合检测预测CHD预后不良的AUC值高于hs-CRP、D-D单项检测,差异有统计学意义(P均<0.05);Hcy单项检测AUC值与联合检测比较,差异无统计学意义(P>0.05)。结论血清hs-CRP、Hcy、D-D水平检测可作为预测CHD预后不良重要指标,且联合检测的预测价值更高,可用于CHD预后评估。Objective To explore the predictive value of combined detection of serum high-sensitivity C-reactive protein(hs-CRP),homocysteine(Hcy),and D-dimer(D-D)for the prognosis of coronary heart disease(CHD).Methods The clinical data of eighty-nine patients with CHD admitted to Jining Municipal Hospital from January 2020 to December 2022 were retrospectively selected.All patients were followed up for 1 year.According to whether there were adverse cardiac events during the follow-up period,they were divided into poor prognosis group(n=33)and good prognosis group(n=56).The levels of serum hs-CRP,Hcy and D-D were compared between the two groups.The adverse factors of CHD prognosis were analyzed.ROC curve was drawn to analyze the predictive value of serum hs-CRP,Hcy,D-D alone and combined detection of CHD.Results The levels of serum hs-CRP,Hcy and D-D in the poor prognosis group were higher than the good prognosis group,and the differences were statistically significant(all P<0.05).Serum hs-CRP(OR=1.956,95%CI=1.709-2.239),Hcy(OR=2.123,95%CI=1.808-2.494),D-D(OR=2.217,95%CI=1.917-2.563)were independent risk factors for poor prognosis of CHD.The AUC value of combined detection of serum hs-CRP,Hcy and D-D in predicting the poor prognosis of CHD was higher than single detection of hs-CRP and D-D,and the differences were statistically significant(both P<0.05).There was no significant difference in AUC value between Hcy single detection and combined detection(P>0.05).Conclusion The detection of serum hs-CRP,Hcy and D-D levels can be used as an important index to predict the poor prognosis of CHD,and the combined detection has higher predictive value and can be used for the prognosis evaluation of CHD.

关 键 词：冠心病 超敏C反应蛋白 同型半胱氨酸 D-二聚体 预后 预测价值 

分 类 号：R446.1[医药卫生—诊断学]