CAJ | 학술논문

目的：观察不同病变程度的冠心病患者血浆胱抑素C (Cyst C)和D-二聚体(DD)水平，探讨Cyst C及DD水平对冠状动脉狭窄病变程度的临床预测价值。方法选取2013年9月至2014年2月我院老干科收治的冠心病患者74例。根据冠脉造影结果将其分为单支病变组24例、双支病变组28例和三支病变组22例。根据冠状动脉Gensini评分结果将其分为轻度狭窄组25例、中度狭窄组20例和重度狭窄组29例。同时选择疑似冠心病患者22例为对照组。用ELISA法分别检测各组受试者血浆中的Cyst C和DD浓度，并应用Pearson进行相关分析。结果单支病变组、双支病变组和三支病变组患者的血浆Csyt C和DD水平均高于对照组(P<0.05)。三支病变组的血浆Cyst C和DD浓度分别为(1.31±0.28) mg/L和(303.46±41.15)μg/L，均高于双支病变组和单支病变组(P<0.05)；双支病变组的血浆Cyst C和DD浓度分别为(1.14±0.22) mg/L和(248.63±31.78)μg/L，均高于单支病变组的(0.93±0.17) mg/L和(215.92±32.86)μg/L (P<0.05)。轻度狭窄组、中度狭窄组和重度狭窄组患者的血浆Csyt C和DD水平均高于对照组(P<0.05)。重度狭窄组的血浆Cyst C和DD浓度分别为(1.35±0.23) mg/L和(293.50±39.24)μg/L，均高于中度狭窄组和轻度狭窄组(P<0.05)；中度狭窄组的血浆Cyst C和DD浓度分别为(1.09±0.27) mg/L和(261.12±40.31)μg/L，均高于轻度狭窄组的(0.94±0.16) mg/L和(211.59±35.46)μg/L (P<0.05)。患者的血浆Cyst C和DD水平均与冠脉Gensini积分呈正相关(r=0.514，0.476，P<0.01)，血浆Cyst C与DD水平呈显著性正相关(r=0.743，P<0.01)。结论冠心病患者血浆Cyst C和DD水平明显升高，随着病变支数的增加及狭窄病变程度而逐渐升高，且与冠状动脉Gensini评分具有正相关性。联合检测血浆Cyst C及DD水平可初步预测冠状动脉狭窄病变程度。
목적：관찰불동병변정도적관심병환자혈장광억소C (Cyst C)화D-이취체(DD)수평，탐토Cyst C급DD수평대관상동맥협착병변정도적림상예측개치。방법선취2013년9월지2014년2월아원로간과수치적관심병환자74례。근거관맥조영결과장기분위단지병변조24례、쌍지병변조28례화삼지병변조22례。근거관상동맥Gensini평분결과장기분위경도협착조25례、중도협착조20례화중도협착조29례。동시선택의사관심병환자22례위대조조。용ELISA법분별검측각조수시자혈장중적Cyst C화DD농도，병응용Pearson진행상관분석。결과단지병변조、쌍지병변조화삼지병변조환자적혈장Csyt C화DD수평균고우대조조(P<0.05)。삼지병변조적혈장Cyst C화DD농도분별위(1.31±0.28) mg/L화(303.46±41.15)μg/L，균고우쌍지병변조화단지병변조(P<0.05)；쌍지병변조적혈장Cyst C화DD농도분별위(1.14±0.22) mg/L화(248.63±31.78)μg/L，균고우단지병변조적(0.93±0.17) mg/L화(215.92±32.86)μg/L (P<0.05)。경도협착조、중도협착조화중도협착조환자적혈장Csyt C화DD수평균고우대조조(P<0.05)。중도협착조적혈장Cyst C화DD농도분별위(1.35±0.23) mg/L화(293.50±39.24)μg/L，균고우중도협착조화경도협착조(P<0.05)；중도협착조적혈장Cyst C화DD농도분별위(1.09±0.27) mg/L화(261.12±40.31)μg/L，균고우경도협착조적(0.94±0.16) mg/L화(211.59±35.46)μg/L (P<0.05)。환자적혈장Cyst C화DD수평균여관맥Gensini적분정정상관(r=0.514，0.476，P<0.01)，혈장Cyst C여DD수평정현저성정상관(r=0.743，P<0.01)。결론관심병환자혈장Cyst C화DD수평명현승고，수착병변지수적증가급협착병변정도이축점승고，차여관상동맥Gensini평분구유정상관성。연합검측혈장Cyst C급DD수평가초보예측관상동맥협착병변정도。
Objective To observe the plasmatic cystatin C (Cys C) and D-dimer (DD) level of coronary heart disease (CHD) patients with different lesion extent, and to explore the clinical predictive value of Cys C and DD on CHD lesions. Methods Seventy-four CHD patients in the department of old cadre between September 2013 and February 2014 were selected. According to the result of coronary angiography, they were divided into One-vessel le-sion group (24 cases), Two-vessel lesion group (28 cases) and Three-vessel lesion group (22 cases). According to the Gensini score, they were divided into mild stenosis group (25 cases), moderate stenosis group (20 cases) and severe stenosis group (29 cases). 22 CHD suspected cases were enrolled as the control group. The plasmatic Cys C and DD levels were measured by ELISA, and their correlation was analyzed by Pearson. Results The plasmatic Cys C and DD of each CHD group (One-vessel lesion group, Two-vessel lesion group and Three-vessel lesion group) were higher than those of the control group (P<0.05). The plasmatic Cys C and DD concentrations of Three-vessel lesion group were (1.31±0.28) mg/L and (303.46±41.15)μg/L, both higher than those of the Two-vessel lesion group and One-vessel lesion group (P<0.05). The plasmatic Cys C and DD concentrations of Two-vessel lesion group were (1.14 ± 0.22) mg/L and (248.63 ± 31.78) μg/L, higher than those of One-vessel lesion group [(0.93 ± 0.17) mg/L and (215.92±32.86)μg/L], P<0.05. The plasmatic Cys C and DD of mild stenosis group, moderate stenosis group, moder-ate stenosis group were higher than those of the control group (P<0.05). The plasmatic Cys C and DD concentration of severe stenosis group were (1.35 ± 0.23) mg/L and (293.50 ± 39.24) μg/L, higher than those of the moderate stenosis group and mild stenosis group (P<0.05). The plasmatic Cys C and DD concentration of moderate stenosis group were (1.09 ± 0.27) mg/L and (261.12 ± 40.31) μg/L, higher than those of the mild stenosis group [(0.94 ± 0.16) mg/L and (211.59 ± 35.46)μg/L], P<0.05. Patients' average plasmatic Cys C and DD level were positively correlated with coro-nary Gensini score (r=0.514, 0.476, P<0.01). And the Cys C level was positively correlated with the DD level (r=0.743, P<0.01). Conclusion The plasmatic Cys C and DD level in CHD patients increased significantly, they could increase gradually with the increase of lesion vessel and stenosis and they were positively correlated between the Gen-sini score of coronary artery. Combined detection of plasmatic Cys C and DD levels could predict the lesion extent of coronary artery stenosis.