中华急诊医学杂志
中華急診醫學雜誌
중화급진의학잡지
CHINESE JOURNAL OF EMERGENCY MEDICINE
2010年
3期
273-276
,共4页
葛长江%任芳%吕树铮%柳弘%宋现涛%陈欣%孟康%吴小凡%苑飞%金泽宁%李红%季凤清
葛長江%任芳%呂樹錚%柳弘%宋現濤%陳訢%孟康%吳小凡%苑飛%金澤寧%李紅%季鳳清
갈장강%임방%려수쟁%류홍%송현도%진흔%맹강%오소범%원비%금택저%리홍%계봉청
胱抑素C%高敏C反应蛋白%冠心病%急性冠脉综合征
胱抑素C%高敏C反應蛋白%冠心病%急性冠脈綜閤徵
광억소C%고민C반응단백%관심병%급성관맥종합정
Cystatin C%hs-CRP%Coronary artery disease%Acute coronary syndrome
目的 探讨血浆胱抑素C水平(plasma eystatin C concentration,PcyC)对冠心病及其预后的临床价值.方法 连续入选2007年4月至2009年3月在北京安贞医院住院经冠脉造影检查确诊为冠心病患者126例,其中稳定型心绞痛(stable angina pectoris,SAP)34例、不稳定型心绞痛(unstable angi-na pectoris,UAP)56例,急性心肌梗死(acute myocardial infarction,AMI)36例,所有患者均符合WHO冠心病的临床诊断标准.设同期因胸闷胸痛症状入院经冠状动脉造影排外冠心病的对照组34例.各组在性别、年龄等一般资料问比较差异无统计学意义,具有可比性.测定其血脂、血尿酸(uric acid,UA)的浓度,以及PcyC和高敏C反应蛋白(high-sensitive C-reactive protein,hs-CRP)水平.对所有患者随访6个月,记录其心血管不良事件的发生情况.两组间、多组间均数比较分别采用t检验和方差分析,计数资料使用χ~2检验,P<0.05为差异具有统计学意义.结果 UAP组PcyC显著高于SAP组和对照组(P<0.05),但低于AMI组(P<0.05);而UAP组和AMI组hs-CRP浓度显著增高(P<0.05;P<0.01).PcyC与年龄、hs-CRP、白细胞总数、血肌酐、UA呈正相关(r>0,P<0.05),其中与血肌酐的相关性最强(r=0.612),白细胞数次之(r=0.459);PcyC与HDL-C呈负相关(r=-0.227,P<0.05).在6个月临床随访中,26例患者发生心血管不良事件,且其人院时PcyC明显高于同期22例未发生心血管不良事件患者(P<0.01).结论 胱抑素C参与了冠心病的发病过程,PcyC是冠心病及其不良预后的一个重要的预测因子.
目的 探討血漿胱抑素C水平(plasma eystatin C concentration,PcyC)對冠心病及其預後的臨床價值.方法 連續入選2007年4月至2009年3月在北京安貞醫院住院經冠脈造影檢查確診為冠心病患者126例,其中穩定型心絞痛(stable angina pectoris,SAP)34例、不穩定型心絞痛(unstable angi-na pectoris,UAP)56例,急性心肌梗死(acute myocardial infarction,AMI)36例,所有患者均符閤WHO冠心病的臨床診斷標準.設同期因胸悶胸痛癥狀入院經冠狀動脈造影排外冠心病的對照組34例.各組在性彆、年齡等一般資料問比較差異無統計學意義,具有可比性.測定其血脂、血尿痠(uric acid,UA)的濃度,以及PcyC和高敏C反應蛋白(high-sensitive C-reactive protein,hs-CRP)水平.對所有患者隨訪6箇月,記錄其心血管不良事件的髮生情況.兩組間、多組間均數比較分彆採用t檢驗和方差分析,計數資料使用χ~2檢驗,P<0.05為差異具有統計學意義.結果 UAP組PcyC顯著高于SAP組和對照組(P<0.05),但低于AMI組(P<0.05);而UAP組和AMI組hs-CRP濃度顯著增高(P<0.05;P<0.01).PcyC與年齡、hs-CRP、白細胞總數、血肌酐、UA呈正相關(r>0,P<0.05),其中與血肌酐的相關性最彊(r=0.612),白細胞數次之(r=0.459);PcyC與HDL-C呈負相關(r=-0.227,P<0.05).在6箇月臨床隨訪中,26例患者髮生心血管不良事件,且其人院時PcyC明顯高于同期22例未髮生心血管不良事件患者(P<0.01).結論 胱抑素C參與瞭冠心病的髮病過程,PcyC是冠心病及其不良預後的一箇重要的預測因子.
목적 탐토혈장광억소C수평(plasma eystatin C concentration,PcyC)대관심병급기예후적림상개치.방법 련속입선2007년4월지2009년3월재북경안정의원주원경관맥조영검사학진위관심병환자126례,기중은정형심교통(stable angina pectoris,SAP)34례、불은정형심교통(unstable angi-na pectoris,UAP)56례,급성심기경사(acute myocardial infarction,AMI)36례,소유환자균부합WHO관심병적림상진단표준.설동기인흉민흉통증상입원경관상동맥조영배외관심병적대조조34례.각조재성별、년령등일반자료문비교차이무통계학의의,구유가비성.측정기혈지、혈뇨산(uric acid,UA)적농도,이급PcyC화고민C반응단백(high-sensitive C-reactive protein,hs-CRP)수평.대소유환자수방6개월,기록기심혈관불량사건적발생정황.량조간、다조간균수비교분별채용t검험화방차분석,계수자료사용χ~2검험,P<0.05위차이구유통계학의의.결과 UAP조PcyC현저고우SAP조화대조조(P<0.05),단저우AMI조(P<0.05);이UAP조화AMI조hs-CRP농도현저증고(P<0.05;P<0.01).PcyC여년령、hs-CRP、백세포총수、혈기항、UA정정상관(r>0,P<0.05),기중여혈기항적상관성최강(r=0.612),백세포수차지(r=0.459);PcyC여HDL-C정부상관(r=-0.227,P<0.05).재6개월림상수방중,26례환자발생심혈관불량사건,차기인원시PcyC명현고우동기22례미발생심혈관불량사건환자(P<0.01).결론 광억소C삼여료관심병적발병과정,PcyC시관심병급기불량예후적일개중요적예측인자.
Objective To evaluate the relationship between plasma cystatin C concentration (PcyC) and coronary artery diseases (CAD). Method A total of 126 subjects with CAD evidenced by coronary angiography admitted from April 2007 to March 2009 were divided into three groups: stable angina pectoris (SAPs, n = 34),unstable angina pectoris (UAPs, n = 56) and acute myocardial infarction (AMIs, n = 36), according to the diag-nostic criteria of CAD set by WHO. Another 34 subjects without CAD were taken as controls. There were no statis-tical differences in demographics among four groups. Serum lipids profile, uric acid (UA), PcyC and high-sensi-tive C-reactive protein (hs-CRP) were determined. And in the meantime, all patients were followed up for six months and adverse cardiovascular events were recorded. Comparisons were made between groups with a number of independent-sample t -tests. Data were processed with analysis of variance to test the differences in means among four groups, and the means were compared with chi-square test. Statistical significance was established at a P val-ue of less than 0.05. Results Cystatin C levels were significantly higher in UAPs than that in SAPs and in controls (P < 0.05), but were much lower than that in AMIs (P < 0.05). And much higher concentration of hs-CRP was found in UAPs (P < 0.05) and in AMIs (P < 0.01). Cystatin C was positively and significantly corre-lated with age, hs-CRP, WBC, creatinine and UA (r > 0, P < 0.05), whereas a significantly negative correla-tion with high-density lipoprotein cholesterol was found (r = - 0.227, P < 0.05). These coefficients were obvi-ously high for creatinine (r = + 0. 612), and WBC (r = + 0.459). During the period of six-month follow-up, 26 patients with adverse cardiovascular events were found, and had significantly higher cystatin C levels than 22 con-trols at admission (P < 0.01). Conclusions Cystatin C plays a pivotal role in the course of CAD, and the PcyC is a strong predictor for the risk of cardiovascular events.
