检验医学与临床
檢驗醫學與臨床
검험의학여림상
Laboratory Medicine and Clinic
2015年
23期
3458-3460
,共3页
周方元%李艳%戴雯%赵锐%许淑文
週方元%李豔%戴雯%趙銳%許淑文
주방원%리염%대문%조예%허숙문
尿酸%β2-微球蛋白%超敏 C 反应蛋白%冠状动脉粥样硬化%慢性心力衰竭
尿痠%β2-微毬蛋白%超敏 C 反應蛋白%冠狀動脈粥樣硬化%慢性心力衰竭
뇨산%β2-미구단백%초민 C 반응단백%관상동맥죽양경화%만성심력쇠갈
uric acid%β2-microglobulinandhigh%high sensitivity C-reactive protein%coronary atheroscle-rosis%chronic heart failure
目的:探讨血脂、脂蛋白‐α[Lp(α)]、尿酸(UA)、β2‐微球蛋白(β2‐MG)及超敏 C 反应蛋白(hs‐CRP)的检测对冠状动脉粥样硬化合并慢性心力衰竭的临床意义。方法选取2014年1~12月武汉大学人民医院的冠状动脉粥样硬化合并慢性心力衰竭患者268例及冠状动脉粥样硬化非心力衰竭患者30例,分别检测各项指标水平,比较不同心功能分级的冠状动脉粥样硬化患者之间各项指标差异并探讨其临床意义。结果不同心功能分级之间比较,血脂及 Lp(α)水平差异均无统计学意义(P>0.05)。随心功能分级的增加,尿酸、β2‐MG 和 hs‐CRP 水平呈上升趋势(F值分别为3.841、10.241、4.065,P<0.05);对 UA 、β2‐MG 及 hs‐CRP 进行组间两两比较显示,与心功能Ⅰ级比较,心功能Ⅱ级β2‐MG 及 hs‐CRP 水平升高(t 值分别为-3.358、-3.513,P<0.05);与心功能Ⅱ级相比较,心功能Ⅲ级β2‐MG 及 hs‐CRP 水平升高(t 值分别为-5.298、-4.666,P <0.05);与心功能Ⅲ级比较,心功能Ⅳ级UA 、β2‐MG 及 hs‐CRP 水平升高(t 值分别为-2.777、-4.386、-2.222,P<0.05)。 Pearson 相关性分析显示,在心功能Ⅰ级β2‐MG 与 TG 呈显著负相关(r=-0.534,P <0.05),hs‐CRP 与 TC 、TG 、LDL‐c 呈显著正相关(r 分别为0.790、0.608、0.753,P<0.05);在心功能Ⅱ级β2‐MG 与 UA 及 hs‐CRP 呈显著正相关(r 分别为0.409、0.420,P<0.05);在心功能Ⅲ级β2‐MG 与 HDL‐C 呈显著负相关(r=-0.302,P<0.05),与 UA 呈显著正相关(r =0.388,P<0.05);在心功能Ⅳ级β2‐MG 与 TG 及 hs‐CRP 呈显著正相关(r 分别为0.623、0.502,P<0.05),hs‐CRP 与 HDL‐C呈显著负相关(r=-0.543,P<0.05)。结论联合检测血清 UA 、β2‐MG 及 hs‐CRP ,可以对冠状动脉粥样硬化患者的心功能进行动态监测为其治疗和预后提供合理参考依据。
目的:探討血脂、脂蛋白‐α[Lp(α)]、尿痠(UA)、β2‐微毬蛋白(β2‐MG)及超敏 C 反應蛋白(hs‐CRP)的檢測對冠狀動脈粥樣硬化閤併慢性心力衰竭的臨床意義。方法選取2014年1~12月武漢大學人民醫院的冠狀動脈粥樣硬化閤併慢性心力衰竭患者268例及冠狀動脈粥樣硬化非心力衰竭患者30例,分彆檢測各項指標水平,比較不同心功能分級的冠狀動脈粥樣硬化患者之間各項指標差異併探討其臨床意義。結果不同心功能分級之間比較,血脂及 Lp(α)水平差異均無統計學意義(P>0.05)。隨心功能分級的增加,尿痠、β2‐MG 和 hs‐CRP 水平呈上升趨勢(F值分彆為3.841、10.241、4.065,P<0.05);對 UA 、β2‐MG 及 hs‐CRP 進行組間兩兩比較顯示,與心功能Ⅰ級比較,心功能Ⅱ級β2‐MG 及 hs‐CRP 水平升高(t 值分彆為-3.358、-3.513,P<0.05);與心功能Ⅱ級相比較,心功能Ⅲ級β2‐MG 及 hs‐CRP 水平升高(t 值分彆為-5.298、-4.666,P <0.05);與心功能Ⅲ級比較,心功能Ⅳ級UA 、β2‐MG 及 hs‐CRP 水平升高(t 值分彆為-2.777、-4.386、-2.222,P<0.05)。 Pearson 相關性分析顯示,在心功能Ⅰ級β2‐MG 與 TG 呈顯著負相關(r=-0.534,P <0.05),hs‐CRP 與 TC 、TG 、LDL‐c 呈顯著正相關(r 分彆為0.790、0.608、0.753,P<0.05);在心功能Ⅱ級β2‐MG 與 UA 及 hs‐CRP 呈顯著正相關(r 分彆為0.409、0.420,P<0.05);在心功能Ⅲ級β2‐MG 與 HDL‐C 呈顯著負相關(r=-0.302,P<0.05),與 UA 呈顯著正相關(r =0.388,P<0.05);在心功能Ⅳ級β2‐MG 與 TG 及 hs‐CRP 呈顯著正相關(r 分彆為0.623、0.502,P<0.05),hs‐CRP 與 HDL‐C呈顯著負相關(r=-0.543,P<0.05)。結論聯閤檢測血清 UA 、β2‐MG 及 hs‐CRP ,可以對冠狀動脈粥樣硬化患者的心功能進行動態鑑測為其治療和預後提供閤理參攷依據。
목적:탐토혈지、지단백‐α[Lp(α)]、뇨산(UA)、β2‐미구단백(β2‐MG)급초민 C 반응단백(hs‐CRP)적검측대관상동맥죽양경화합병만성심력쇠갈적림상의의。방법선취2014년1~12월무한대학인민의원적관상동맥죽양경화합병만성심력쇠갈환자268례급관상동맥죽양경화비심력쇠갈환자30례,분별검측각항지표수평,비교불동심공능분급적관상동맥죽양경화환자지간각항지표차이병탐토기림상의의。결과불동심공능분급지간비교,혈지급 Lp(α)수평차이균무통계학의의(P>0.05)。수심공능분급적증가,뇨산、β2‐MG 화 hs‐CRP 수평정상승추세(F치분별위3.841、10.241、4.065,P<0.05);대 UA 、β2‐MG 급 hs‐CRP 진행조간량량비교현시,여심공능Ⅰ급비교,심공능Ⅱ급β2‐MG 급 hs‐CRP 수평승고(t 치분별위-3.358、-3.513,P<0.05);여심공능Ⅱ급상비교,심공능Ⅲ급β2‐MG 급 hs‐CRP 수평승고(t 치분별위-5.298、-4.666,P <0.05);여심공능Ⅲ급비교,심공능Ⅳ급UA 、β2‐MG 급 hs‐CRP 수평승고(t 치분별위-2.777、-4.386、-2.222,P<0.05)。 Pearson 상관성분석현시,재심공능Ⅰ급β2‐MG 여 TG 정현저부상관(r=-0.534,P <0.05),hs‐CRP 여 TC 、TG 、LDL‐c 정현저정상관(r 분별위0.790、0.608、0.753,P<0.05);재심공능Ⅱ급β2‐MG 여 UA 급 hs‐CRP 정현저정상관(r 분별위0.409、0.420,P<0.05);재심공능Ⅲ급β2‐MG 여 HDL‐C 정현저부상관(r=-0.302,P<0.05),여 UA 정현저정상관(r =0.388,P<0.05);재심공능Ⅳ급β2‐MG 여 TG 급 hs‐CRP 정현저정상관(r 분별위0.623、0.502,P<0.05),hs‐CRP 여 HDL‐C정현저부상관(r=-0.543,P<0.05)。결론연합검측혈청 UA 、β2‐MG 급 hs‐CRP ,가이대관상동맥죽양경화환자적심공능진행동태감측위기치료화예후제공합리삼고의거。
Objective To investigate the clinical significance of the detection of serum lipid ,lipoprotein‐α [Lp (α)] ,uric acid (UA) ,β2‐microglobulinandhigh (β2‐MG) and high sensitivity C‐reactive protein (hs‐CRP) in coronary atherosclerosis patients with chronic heart failure .Methods From January 2014 to December 2014 ,268 cases of coro‐nary atherosclerosis patients with chronic heart failure and 30 cases of coronary atherosclerosis patients without heart failure were collected in Renmin Hospital of Wuhan University .The levels of serum lipid ,Lp(α) ,UA ,β2‐MG and hs‐CRP were detected ,and the differences of the indicators between coronary atherosclerosis patients with different car‐diac functional grades .Results Among coronary atherosclerosis patients with different cardiac functional grades , there was no differences of serum liquid and Lp(α) levels (P> 0 .05) .The levels of UA ,β2‐MG and hs‐CRP increased with the cardiac functional grade (F= 3 .841 ,10 .241 and 4 .065 ,P< 0 .05) .The pairwise comparison of UA ,β2‐MG and hs‐CRP showed that β2‐MG and hs‐CRP levels of patients with cardiac functional grade Ⅱ were significantly higher than those of patients with cardiac functional grade Ⅰ (t= - 3 .358 ,- 3 .513 ,P< 0 .05) ;patients with cardiac functional grade Ⅲ had significantly higherβ2‐MG and hs‐CRP levels than patients with cardiac functional grade Ⅱ(t= - 5 .298 ,- 4 .666 ,P< 0 .05) ;and patients with cardiac functional grade Ⅳ had significantly higher UA ,β2‐MG and hs‐CRP levels than patients with cardiac functional grade Ⅲ (t= - 2 .777 ,- 4 .386 ,- 2 .222 ,P< 0 .05) .Pearson correlation analysis showed that β2‐MG was negatively correlated with TG (r = - 0 .534 ,P< 0 .05) ,hs‐CRP was pos‐itively correlated with TC ,TG ,LDL‐C (r= 0 .790 ,0 .608 ,0 .753 ,P< 0 .05) in patients with cardiac functional gradeⅠ ;β2‐MG was positively correlated with UA and hs‐CRP (r= 0 .409 and 0 .420 ,P< 0 .05) in patients with cardiac functional grade Ⅱ ;β2‐MG was negatively correlated with HDL‐C (r = - 0 .302 ,P< 0 .05) ,and positively correlated with UA (r= 0 .388 ,P < 0 .05) in patients with cardiac functional grade Ⅲ ;β2‐MG was positively correlated with TG and hs‐CRP (r= 0 .623 ,0 .502 ,P< 0 .05) ,and hs‐CRP was negatively correlated with HDL‐C (r = - 0 .543 ,P<0 .05) in patients with cardiac functional grade Ⅳ .Conclusion Combined detection of serum UA ,β2‐MG and hs‐CRP can dynamically monitor the heart function of patients with coronary atherosclerosis and provide a reasonable refer‐ence for the treatment and prognosis .