| 黄其峰,赵寅生,贾健安,等.急性冠脉综合征病人超敏 C反应蛋白、胱抑素 C和同型半胱氨酸与全球急性冠状动脉事件注册评分的相关性分析[J].安徽医药,2023,27(12):2408-2411. |
| 急性冠脉综合征病人超敏 C反应蛋白、胱抑素 C和同型半胱氨酸与全球急性冠状动脉事件注册评分的相关性分析 |
| Correlation analysis of hs-CRP, CysC, and HCY with the GRACE score in patients with acute coronary syndrome |
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| DOI：10.3969/j.issn.1009-6469.2023.12.016 |
| 中文关键词: 急性冠脉综合征 动脉粥样硬化 超敏 C反应蛋白 血清胱抑素 C 血清同型半胱氨酸 |
| 英文关键词: Acute coronary syndrome Atherosclerosis High sensitivity C-reactive protein Serum cystatin C Serum homo. cysteine |
| 基金项目:安徽省自然科学基金(2008085QH372) |
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| 中文摘要: |
| 目的回顾性分析急性冠脉综合征(ACS)病人超敏 C反应蛋白(hs-CRP)、胱抑素 C(CysC)及同型半胱氨酸(HCY)水平与全球急性冠状动脉事件注册(GRACE)评分的相关性。方法选取 2019年 1月至 2021年 12月中国人民解放军联勤保障部队第九〇一医院收治的疑似 ACS病人 170例，经冠状动脉造影确诊为急性心肌梗死(AMI)组 32例，不稳定心绞痛(UAP)组 58例、冠状动脉粥样硬化组 46例，冠状动脉正常组 34例。根据 GRACE评分规则将冠状动脉异常病人分为低危组 56例、中危组 41例和高危组 39例，选取同期 90例健康体检者作为对照组；检测血清 hs-CRP、CysC、HCY等指标，并进行统计分析。结果冠状动脉正常组 hs-CRP、CysC和HCY［(0.72±0.64)mg/L、(0.72±0.17)mg/L、(10.23±2.16)μmol/L］和状动脉粥样硬化组［(1.32±0.78)mg/L、(1.29±0.41)mg/L、(11.45±3.84)μmol/L］，差异有统计学意义(P<0.05)；AMI组和 UAP组之间 hs-CRP［(17.44±6.44) mg/L、(13.28±4.89)mg/L］和 CysC［(1.81±0.71)mg/L、(1.57±0.64)mg/L］差异有统计学意义(P<0.05)其余指标差异无统计学意义(P>0.05)；高危组、中危组、低危组病人三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDLs-CRP、HCY和 CysC表)、h，达水平均显著高于对照组，高密度脂蛋白胆固醇(HDL)显著低于对照组，差异有统计学意义(P<0.05)；高危组、中危组、低危组之间 TG、TC、LDL和 HDL表达水平差异无统计学意义(P>0.05)；高危组 hs-CRP、HCY和 CysC表达水平［(17.50±2.68)mg/L、(17.83±1.87)μmol/L、(1.68±0.56)mg/L］显著高于中危组［(9.65±1.52)mg/L、(16.61±1.85)μmol/L、(1.37±0.35)mg/L］和低危组［(5.81±1.33)mg/L、(12.38±2.14)μmol/L、(1.14±0.45)mg/L］，中危组显著高于低危组，均差异有统计学意义(P<0.05)；随着 GRACE评分增加 hs-CRP、HCY和 CysC表达水平不断增加，呈显著正相关(r=0.86、0.72、0.70，均 P<0.05)。结论 hs-CRP、CysC和 HCY在 ACS病人中的表达明显升高，与 GRACE评分存在显著正相关，对预测 ACS病人预后情况具有较高诊断价值，可作为预测 ACS危险分层判断指标，具有重要的临床诊断价值。 |
| 英文摘要: |
| Objective To retrospectively analyze the correlation between high sensitivity C-reactive protein (hs-CRP), serum cys.tatin C (CysC), and serum homocysteine (HCY) levels and Global Registry of Acute Coronary Event (GRACE) scores in patients withacute coronary syndrome (ACS).Methods A total of 170 patients with suspected ACS admitted to the No. 901 Hospital of the Joint Lo.gistics Support Force of the People's Liberation Army of China from January 2019 to December 2021 were selected. There were 32 cas.es in the acute myocardial infarction (AMI) group, 58 cases in the unstable angina pectoris (UAP) group, 46 cases in the coronary ath.erosclerosis group and 34 cases in the normal coronary artery group, which were diagnosed by coronary angiography. According to theGRACE score rules, patients with coronary artery abnormalities were divided into the low-risk group (n=56), the medium-risk group (n= 41) and the high-risk group (n=39), and 90 healthy patients who had medical checkups during the same period were selected as the con. trol group; serum hs-CRP, CysC, HCY and other indexes were detected and statistically analyzed. Results The hs-CRP, CysC and HCY [(0.72±0.64) mg/L, (0.72±0.17) mg/L, (10.23±2.16) μmol/L] in the coronary normal group and hs-CRP, CysC, and HCY in the ath.erosclerotic group [(1.32±0.78) mg/L, (1.29±0.41) mg/L, (11.45±3.84) μ and the differences in the rest of the indicators were not statisti.cally significant (P< 0.05). The differences in hs-CRP [(17.44±6.44) mg/L, (13.28±4.89) mg/L] and CysC [(1.81±0.71) mg/L, (1.57±0.64) mg/L] were statistically significant between the AMI group and the UAP group (P<0.05), while the differences in the rest of the in. dexes were statistically insignificant (P>0.05). The expression levels of triglyceride (TG), total cholesterol (TC), low-density lipoprotein (LDL), hs-CRP, HCY and CysC were significantly higher than those of the control group, and serum high-density lipoprotein cholesterol (HDL) was significantly lower than that of the control group between the patients in the high-risk group, intermediate-risk group, and low-risk group, with statistically significant differences (P<0.05). There was no significant difference in the expression levels of TG, TC, LDL and HDL among the high-risk group, the medium-risk group and the low-risk group (P>0.05). The expression levels of hs-CRP, HCY and CysC in the high-risk group [(17.50±2.68) mg/L, (17.83±1.87) μmol/L, (1.68±0.56) mg/L] were significantly higher than those in the medium-risk group [(9.65±1.52) mg/L, (16.61±1.85) μmol/L, (1.37±0.35) mg/L] and the low-risk group [(5.81±1.33) mg/L,(12.38± 2.14) μmol/L, (1.14±0.45) mg/L], and the medium-risk group was significantly higher than that of the low-risk group, and the difference of all of them was statistically significant (P<0.05). With the increase in the GRACE score, the expression levels of hs-CRP, HCY and CysC increased continuously, showing a significant positive correlation (r=0.86, 0.72, 0.70, all P<0.05).Conclusions The expression of hs-CRP, CysC and HCY was significantly increased in ACS patients, and there was a significant positive correlation with the GRACEscore, which has high diagnostic value in predicting the prognosis of ACS patients and can be used as a predictive indicator for the judg.ment of the risk stratification of ACS, which is of important clinical diagnostic value. |
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