CAJ | 학술논문

目的观察老年急性冠脉综合征（ACS）患者血清铁蛋白（SF）、血脂与冠状动脉（冠脉）狭窄程度的关系，评价SF对冠心病的诊断价值。方法①对125例老年ACS患者（男性65例，女性60例）进行冠脉造影检查，并对总胆固醇（TC）、三酰甘油（TG）、高密度脂蛋白（HDL-C）、低密度脂蛋白（LDL-C）、SF进行测定；依据冠脉造影结果，采用Gensini评分计算冠脉狭窄程度，将观察对象分为轻（42例）、中（45例）、重度（38例）组，比较SF、血脂水平在3组间的差异，分析SF及血脂与冠脉病变狭窄程度的关系。②将老年ACS患者分为男性及女性两组，比较两组间SF和Gensini评分的差异。③比较65例老年男性ACS患者与60例中年男性ACS患者SF和Gensini评分的差异。结果①方差分析显示，SF、TC、LDL-C在轻、中、重度3组间分布差异有统计学意义〔SF（μg/L）：147.287±73.838、162.313±94.882、290.421±194.501，TC（mmol/L）：4.423±0.900、4.998±0.740、5.032±1.009，LDL-C（mmol/L）：3.150±0.799、3.439±0.839、3.902±1.053，均 P＜0.01〕，而TG、HDL-C在各组间分布差异无统计学意义（均P＞0.05）；老年ACS患者SF与Gensini评分呈正相关（r＝0.355，P＝0.000），TC、TG、LDL-C、HDL-C与Gensini评分无相关性（r＝0.090、-0.170、0.256、-0.060，P＝0.532、0.092、0.089、0.537）。②老年男性ACS患者及老年女性ACS患者比较，SF及Gensini评分差异均无统计学意义（均P＞0.05）。③老年男性ACS患者SF及Gensini评分与中年男性ACS患者比较差异也无统计学意义（均P＞0.05）。结论 ACS的发生与SF及血脂有一定的相关性，且冠脉病变严重程度与SF相关，SF对ACS的诊断价值无年龄及性别的差异。
목적관찰노년급성관맥종합정（ACS）환자혈청철단백（SF）、혈지여관상동맥（관맥）협착정도적관계，평개SF대관심병적진단개치。방법①대125례노년ACS환자（남성65례，녀성60례）진행관맥조영검사，병대총담고순（TC）、삼선감유（TG）、고밀도지단백（HDL-C）、저밀도지단백（LDL-C）、SF진행측정；의거관맥조영결과，채용Gensini평분계산관맥협착정도，장관찰대상분위경（42례）、중（45례）、중도（38례）조，비교SF、혈지수평재3조간적차이，분석SF급혈지여관맥병변협착정도적관계。②장노년ACS환자분위남성급녀성량조，비교량조간SF화Gensini평분적차이。③비교65례노년남성ACS환자여60례중년남성ACS환자SF화Gensini평분적차이。결과①방차분석현시，SF、TC、LDL-C재경、중、중도3조간분포차이유통계학의의〔SF（μg/L）：147.287±73.838、162.313±94.882、290.421±194.501，TC（mmol/L）：4.423±0.900、4.998±0.740、5.032±1.009，LDL-C（mmol/L）：3.150±0.799、3.439±0.839、3.902±1.053，균 P＜0.01〕，이TG、HDL-C재각조간분포차이무통계학의의（균P＞0.05）；노년ACS환자SF여Gensini평분정정상관（r＝0.355，P＝0.000），TC、TG、LDL-C、HDL-C여Gensini평분무상관성（r＝0.090、-0.170、0.256、-0.060，P＝0.532、0.092、0.089、0.537）。②노년남성ACS환자급노년녀성ACS환자비교，SF급Gensini평분차이균무통계학의의（균P＞0.05）。③노년남성ACS환자SF급Gensini평분여중년남성ACS환자비교차이야무통계학의의（균P＞0.05）。결론 ACS적발생여SF급혈지유일정적상관성，차관맥병변엄중정도여SF상관，SF대ACS적진단개치무년령급성별적차이。
Objective To investigate the relationships between level of serum ferritin(SF)/blood lipid and the degree of coronary artery stenosis in elderly patients with acute coronary syndrome(ACS),and evaluate the value of SF in the diagnosis of coronary heart disease. Methods ①One hundred and twenty-five elderly patients with ACS(65 males,60 females)underwent coronary angiography examination,and the total cholesterol(TC), triglycerides(TG),high-density lipoprotein(HDL-C),low density lipoprotein(LDL-C)and SF were determined;according to the results of coronary angiography,the degree of coronary artery stenosis was obtained by using the Gensini score and the degrees of severity of stenosis were divided into three groups:light(42 cases),medium (45 cases)and severe(38 cases). The differences in levels of SF and blood lipids among the three groups were observed,and the relationships between the level of SF/blood lipids and various degrees of coronary artery stenoses were analyzed.②The elderly patients with ACS were divided into two groups,male and female,to compare the SF numerical value and Gensini score between the two groups. ③The SF numerical value and Gensini score of 65 senile male cases with ACS were compared to those of 60 middle aged male cases with the same disease. Results ①Variance analysis showed that SF,TC,LDL-C distribution had significant differences among light,medium and severe groups〔SF(μg/L):147.287±73.838,162.313±94.882,290.421±194.501;TC(mmol/L):4.423±0.900,4.998±0.740, 5.032±1.009;LDL-C(mmol/L):3.150±0.799,3.439±0.839,3.902±1.053,all P<0.01〕,while TG,HDL-C distribution among these groups had no such statistically significant differences(all P>0.05);in elderly patients with ACS,SF was positively correlated with Gensini score(r=0.355,P=0.000),while there was no correlation between Gensini score and any one of the following lipids:TC,TG,LDL-C,HDL-C(r=0.090,-0.170,0.256,-0.060,P=0.532,0.092,0.089,0.537).②The comparisons of SF value and Gensini score between senile male and senile female patients with ACS showed no significant differences(all P>0.05).③The comparisons of SF value and Gensini score between senile and middle aged male patients with ACS also showed no significant differences(all P>0.05). Conclusion The occurrence of ACS has certain correlation with SF and lipids,the degree of severity in coronary artery lesion is associated with SF,and there are no differences in age and sex in relation to the value of SF in the diagnosis of ACS.