CAJ | 학술논문

目的：探讨同型半胱氨酸(HCY)、血清超敏C-反应蛋白(HS-CRP)、脂蛋白a[LP(a)]和D-二聚体(DD)联合检测在冠心病病程中应用的意义。方法：将不同类型的冠心病患者198例：急性心肌梗死(AMI)组46例、稳定型心绞痛(SAP)组54例、不稳定型心绞痛(UAP)组56例、隐匿性冠心病(无症状性心肌缺血)42例设为冠心病组，将同期体检合格的健康人216例设为对照组，分别检测血清HCY、HS-CRP、LP(a)和DD的水平。结果：冠心病组HCY、HS-CRP、LP(a)和DD含量均明显高于对照组(P＜0.05)，对照组上述各项指标均在正常范围内。 AMI组、UAP组Hcy、HS-CRP、LP(a)和DD含量明显高于SAP组和无症状性心肌缺血组(P＜0.05)；Hcy、HS-CRP、LP(a)和DD含量随冠心病进展呈逐渐增高趋势；无症状性心肌缺血组，UAP组，SAP组，AMI组四项联合检测的阳性率均高于HCY，Hs-CRP，LP(a)，DD单独检测的阳性率(P＜0.05)；无症状性心肌缺血组，UAP组， SAP组，AMI组四项联合检测的阳性率和单独检测的阳性率随病程延长均逐渐提高。结论：HCY、HS-CRP、LP(a)和DD联合检测能更好地反映冠心病患者的病情程度，可以作为评估冠心病患者病情严重程度的敏感指标，对冠心病的预防和早期诊断及动态监测病情有十分重要的临床价值。
목적：탐토동형반광안산(HCY)、혈청초민C-반응단백(HS-CRP)、지단백a[LP(a)]화D-이취체(DD)연합검측재관심병병정중응용적의의。방법：장불동류형적관심병환자198례：급성심기경사(AMI)조46례、은정형심교통(SAP)조54례、불은정형심교통(UAP)조56례、은닉성관심병(무증상성심기결혈)42례설위관심병조，장동기체검합격적건강인216례설위대조조，분별검측혈청HCY、HS-CRP、LP(a)화DD적수평。결과：관심병조HCY、HS-CRP、LP(a)화DD함량균명현고우대조조(P＜0.05)，대조조상술각항지표균재정상범위내。 AMI조、UAP조Hcy、HS-CRP、LP(a)화DD함량명현고우SAP조화무증상성심기결혈조(P＜0.05)；Hcy、HS-CRP、LP(a)화DD함량수관심병진전정축점증고추세；무증상성심기결혈조，UAP조，SAP조，AMI조사항연합검측적양성솔균고우HCY，Hs-CRP，LP(a)，DD단독검측적양성솔(P＜0.05)；무증상성심기결혈조，UAP조， SAP조，AMI조사항연합검측적양성솔화단독검측적양성솔수병정연장균축점제고。결론：HCY、HS-CRP、LP(a)화DD연합검측능경호지반영관심병환자적병정정도，가이작위평고관심병환자병정엄중정도적민감지표，대관심병적예방화조기진단급동태감측병정유십분중요적림상개치。
Objective: To explore the meaning of homocysteine (HCY), high-sensitivity C-reactive protein (HS-CRP), lipoprotein a [LP(a)] and D-dimer (DD) joint detection applied to the duration of coronary heart disease (CHD). Methods:All 198 patients with different patterns of CHD including 46 cases of acute myocardial infarction (AMI), 54 cases of stable angina pectoris (SAP), 56 cases of unstable angina pectoris (UAP) and 42 cases of latent coronary heart disease (silent myocardial ischemia, SMI) were taken as CHD group, at the same time, 216 healthy persons who were qualified in physical examinations were established as the control group, the levels of HCY, HS-CRP, LP (a) and DD were detected respectively. Results: CHD group was obviously higher than the control group in the contents of HCY, HS-CRP, LP(a) and DD (P<0.05), the indexes above of the control group were dis-tributed in the normal ranges. AMI group and UAP group were eividently higher than SAP group and SMI group in the contents of HCY, HS-CRP, LP(a) and DD (P<0.05);the contents of HCY, HS-CRP, LP(a) and DD were raised gradually as the progression of CHD was developed; four indexes positive rates of joint detection in UAP group, SAP group, AMI group were higher than single item positive rate of HCY, HS-CRP, LP(a) and DD (P<0.05);four indexes positive rates in SMI group, UAP group, SAP group and AMI group and single index positive rate were gradually improved as CHD prolonged. Conclusion:Joint detection of HCY, HS-CRP, LP (a) and DD could reflect CHD patients' conditions better, they could be sensitive indexes of evaluating CHD patients' conditions, and they own important clinical values for the prediction, early diagnosis and dynamic monitoring of CHD.