尿毒症患者血液透析前后血清sCD40、sCD40L和CRP水平的变化及意义

目的探讨尿毒症患者血液透析(HD)前后血清中可溶性CD40(sCD40)、可溶性CD40配体(sCD40L)和C反应蛋白(CRP)的变化规律及其在肾损伤中的可能作用。方法采用酶联免疫吸附试验(ELISA法)测定sCD40和sCD40L,免疫比浊法测定C反应蛋白(CRP)检测50例健康人(对照组)、100例维持性血液透析患者(HD组)血液透析前、后血清sCD40、sCD40L、CRP和血清肌酐(SCr)的水平。结果 HD组血清sCD40、sCD40L、CRP和SCr水平明显高于对照组(P<0.01),HD伴冠心病组sCD40、sCD40L和CRP水平与不伴冠心病组比较差异亦有统计学意义(P<0.01);血液透析后血清CRP水平较透析前显著升高(P<0.01),sCD40L和SCr水平明显下降(P<0.01);相关分析显示,尿毒症血透患者血清中sCD40、sCD40L、CRP和SCr之间呈正相关关系(r=0.668,r=0.549,r=0.721,均P<0.01)。结论血液透析患者存在微炎症状态,sCD40、sCD40L和CRP协同发挥微炎症及细胞毒效应,共同参与了尿毒症患者肾脏损伤的病理过程,亦可能参与了动脉粥样硬化的形成,可作为间接判断血液透析患者预后的预测指标。     

腹膜透析患者C反应蛋白水平与营养不良及心血管疾病的相关性

目的探讨腹膜透析（continuous ambulatory peritoneal dialysis,CAPD）患者C反应蛋白水平的改变及炎症反应与营养不良及心血管疾病的关系。方法检测健康对照者、尿毒症非透析患者和持续性非卧床腹膜透析（CAPD）患者C反应蛋白（CRP）,血清白蛋白（Alb）,血红蛋白（Hb）,血清铁蛋白（SF）,血清前白蛋白（PA）等指标。并根据CAPD患者CRP水平将其分为正常组（CRP〈10mg/L）,异常组（CRP〉10mg/L）,观察2组之间的差别。结果尿毒症非透析组和CAPD组CRP水平均高于对照组[（12.14±5.92）mg/L与（13.92±4.67）mg/L比（5.37±2.15）mg/L,t=8.16,t=12.95,P〈0.001],CAPD组CRP水平高于尿毒症非透析组[（13.92±4.67）mg/L比（12.14±5.92）mg/L,t=2.70,P〈0.01]。CAPD患者CRP水平与营养不良指标Alb,Hb,PA成负相关,有统计学意义（r=-0.44,P=0.007;r=-0.57,P=0.002;r=-0.36,P=0.010）,CRP水平与改良定量的整体营养评估（MQSGA）呈正相关,有统计学意义（r=0.26,P=0.048）。CAPD患者CRP水平升高组的心血管疾病发生率高于CRP正常组（？2=3.86,P〈0.05）,CRP水平与心脏超声检查指标左房内径（LAD）、左室舒张末内径（LVDd）、室间隔厚度（IVST）、左室后壁后度（LVPWT）呈正相关（r=0.315,P=0.028;r=0.252,P=0.049;r=0.297,P=0.035;r=0.349,P=0.020）有统计学意义,与左室射血分数（LVEF）呈负相关（r=-0.281,P=0.041）,有统计学意义。结论 CAPD患者存在CRP水平升高的炎症反应,且高于尿毒症非透析患者,CAPD患者营养不良及心血管疾病与慢性炎症状态相关。     

Relationship of serum osteoprotegerin levels with coronary artery disease severity, left ventricular hypertrophy and C-reactive protein

OPG (osteoprotegerin) is an inhibitor of osteoclastogenesis and recent work suggests it has a role in atherosclerosis. Therefore we measured serum OPG levels in patients with coronary artery disease, compared the serum OPG levels among the different groups according to the number of stenotic vessels and determined whether there was any correlation with aortic calcification, LV (left ventricular) mass index and serum CRP (C-reactive protein) levels. Subjects (n=100; mean age, 57 years) who underwent coronary angiograms were enrolled. Blood pressure, body mass index, fasting blood glucose, lipid profiles and CRP levels were measured and the LV mass indices were calculated using ECGs. Serum OPG levels were measured by ELISA. The presence of calcification in the aortic notch was checked by a chest X-ray. The subjects were divided into four groups according to the number of stenotic vessels. The mean serum OPG levels increased significantly as the number of stenotic vessels increased, and the mean serum OPG levels were higher in the group with three-vessel disease compared with the groups with no- or one-vessel disease. The mean serum CRP level was significantly higher in the group with three-vessel disease compared with the groups with no-, one- and two-vessel disease. Age and LV mass index showed significant positive correlations with serum OPG levels, although significance was lost after an adjustment for age. Serum CRP levels were positively correlated with serum OPG levels even after an adjustment for age. There were no differences in serum OPG levels according to the presence of fasting hyperglycaemia or aortic calcification. In conclusion, serum OPG level was related to the severity of stenotic coronary arteries and serum CRP levels. LV mass indices showed no significant correlation with OPG levels. The precise mechanism for the role of OPG in atherosclerosis needs to be investigated further.     

原发性高血压伴高尿酸血症与冠心病发生的相关性研究

目的:探讨在原发性高血压病患者中,高尿酸血症与冠心病的关系。方法:观察121例原发性高血压病及原发性高血压病伴冠心病患者血尿酸浓度及总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇等冠心病危险因素,用冠状动脉造影方法确诊冠心病。结果:高血压伴冠心病组患者血尿酸浓度及高尿酸血症发生率高于单纯高血压组;血尿酸浓度越高,冠状动脉病变支数越多。结论:高尿酸血症是冠心病的一个危险因素,有必要监测及及时干预高血压患者的血尿酸浓度。     

冠心病患者幽门螺杆菌感染与C反应蛋白、血脂相互关系的研究

目的探讨冠心病(CHD)患者幽门螺杆菌(Hp)感染与C反应蛋白(CRP)、血脂的相互关系,探讨其可能的发病机制。方法对2004年3月至2005年1月深圳市罗湖区人民医院心内科收治的70例CHD患者,按临床诊断分为2组,采用酶联免疫吸附试验(ELISA)法检测急性心肌梗死(AMI)组、心绞痛(AP)组及对照组患者各35例外周血Hp抗体(HpIgG),同时测定血脂及CRP。结果AMI组、AP组及对照组血清HpIgG抗体阳性率分别为54.3%、45.7%及25.7%,AMI组、AP组分别与对照组比较差异有统计学意义(P<0.05),但AMI组与AP组间比较差异无统计学意义;血清CRP及血脂总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白A(apoA)AMI组、AP组显著高于对照组(P<0.01),而高密度脂蛋白胆固醇(HDL-C)AMI组、AP组显著低于对照组(P<0.01),AMI组也明显低于AP组(P<0.01);Hp感染者HpIgG水平与血中CRP、TG、LDL-C及apoA有明显相关性(r分别为0.44、0.64、0.36和0.32),而与HDL-C成负相关(r=-0.78)(P<0.01)。结论CHD患者Hp感染率明显增高,Hp可能通过炎症反应及影响脂质代谢在CHD的发生、发展中起作用。     

Evaluation of C-reactive protein, a sensitive marker of inflammation, as a risk factor for stable coronary artery disease.

OBJECTIVES: Multiple lines of investigations have converged to suggest a prominent role for inflammation in coronary artery disease (CAD). The association of CRP level with active CAD is well documented. The relation, however, between levels of CRP and the presence and extent of stable CAD has seldom been studied in the developing countries. We investigated the association between serum concentration of C-reactive protein (CRP) and angiographically documented coronary artery disease (CAD) in a population of 450 individuals. DESIGN AND METHODS: Ultrasensitive immunoassay was used to measure CRP levels in 284 patients with CAD and 166 control healthy subjects. The association of CRP levels with severity of disease as indicated by > or = 50% stenosis in one vessel (n = 79), two vessels (n = 74), or three vessels (n = 131) was also investigated. RESULTS: CRP levels were greater in the patients with CAD (2.14 (0.88--3.38) vs. 1.45 (0.70--2.55) mg/L, p < 0.0001) than in the respective control subjects. Multiple logistic regression analysis showed CRP as an independent discriminating risk factor for CAD (odds ratio, 3.46, p < 0.001). Significant correlation was identified between CRP levels and severity of CAD (p < 0.0001). Prediction models that incorporated CRP in addition to other established coronary risk factors were significantly better at predicting risk than the models based on the other risk factors alone. CRP level was also an independent predictor of CAD in a subpopulation with normal levels of low density lipoprotein cholesterol (LDL-C < or = 3.4 mmol/L, p < 0.009). CONCLUSIONS: Our findings suggest that CRP has a strong association with stable CAD, as such, the measurement of CRP may improve the coronary risk assessment in Iranian CAD patients.     

冠心病患者血清脂联素与C-反应蛋白关系的研究

目的探讨冠心病患者血清脂联素及C-反应蛋白（CRP）的关系。方法临床及冠状动脉造影明确诊断的冠心病患者46例（冠心病组）和冠状动脉造影基本正常的患者30例（对照组），分别检测其血清脂联素、CRP水平，并进行比较。结果与对照组比较，冠心疯芦血清脂联素水平明显降低（P〈0．01），CRP水平明显升高（P〈0．01），两者之间呈负相关关系（r=-0．26，P〈0．05）。结论冠心病患者血清脂联素水平降低，其与CRP之间的相互关系可能促进了动脉粥样硬化的发展。     

Quality of life in chronic kidney disease: effects of treatment modality, depression, malnutrition and inflammation

In the present study, our aim is to investigate the effects of the treatment modality, depression, malnutrition and inflammation on quality of life (QoL) in chronic kidney disease (CKD). Twenty-six patients with CKD on conservative management, 68 patients on haemodialysis (HD), 47 patients on continuous ambulatory peritoneal dialysis (CAPD) and 66 healthy controls were enrolled in the study. QoL was measured by means of the Short Form-36 (SF-36) and subscale scores were calculated. All patients were evaluated for the presence of depression using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Axis I Disorders - Clinician Version. The severity of depression was evaluated by means of the Beck Depression Inventory (BDI). Serum C-reactive protein (CRP), ferritin, albumin, haemoglobin and haematocrit (Hct) levels were measured. All the SF-36 subscale scores were lower in the patient groups compared with control group. The SF-36 scores were higher and BDI scores were lower in the CAPD group than CKD and HD groups. In patients with depression, all SF-36 subscale scores were lower than that of the patients without depression. There was a significant negative correlation between all the SF-36 subscale scores and the BDI scores. There was a significant positive correlation between the SF-36 physical and total summary scores and the Hct value and serum albumin levels, but an inverse correlation between the SF-36 physical, mental and total summary scores and the serum CRP level in the HD patients. The authors suggest that the treatment modality, depression, malnutrition and inflammation have an important role on QoL in CKD.     

冠心病患者血清内脂素和脂联素水平的变化及临床意义

目的结合C反应蛋白(CRP),探讨血清内脂素、脂联素与冠心病的关系及可能的作用机制。方法将经冠状动脉造影确诊的270例冠心病患者根据临床表现分为3组:稳定性心绞痛(SAP)组125例、不稳定性心绞痛(UAP)组109例、急性心肌梗死(AMI)组36例。另选取健康体检者20名作为对照组。采用酶联免疫吸附试验(ELISA)测定血清内脂素、脂联素水平。同时检测CRP、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、空腹血糖(FPG)、丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、尿素氮(BUN)及肌酐(Cr)水平。采用多元相关分析方法分析内脂素、脂联素与其他指标之间的相关性。结果冠心病组血清CRP、内脂素水平均明显高于对照组(P均﹤0.01);脂联素水平则低于对照组(P<0.01)。AMI组、UAP组及SAP组间血清CRP、内脂素和脂联素差异均有统计学意义(P均﹤0.05)。多元相关分析显示,血清内脂素与CRP、TG、LDL-C呈正相关(r分别为0.929、0.756、0.793,P均<0.001),与脂联素及HDL-C呈负相关(r分别为-0.351、-0.699,P均<0.001);脂联素与CRP、TG及LDL-C呈负相关(r分别为-0.873、-0.639、-0.799,P均﹤0.001);与HDL-C呈正相关(r=0.681,P<0.001)。结论血清内脂素、脂联素均可能是冠心病的危险因素,推测二者可能与CRP相互作用、共同参与了冠心病的发生发展。     

Comparison of coronary artery calcification and some coronary artery calcification risk factors in patients on haemodialysis and in patients with type 2 diabetes

Patients on haemodialysis (HD) and patients with type 2 diabetes are at high-risk for coronary artery calcification (CAC). The coronary artery calcium score (CACS), quantified by computed tomography, cannot be completely explained by traditional cardiovascular disease risk factors. CAC was measured in 45 non-diabetic chronic kidney disease patients on HD and in 45 matched type 2 diabetes patients without diabetic nephropathy. Serum calcium, phosphate, 25-hydroxyvitamin D (25[OH]D), alkaline phosphatase, intact parathyroid hormone (iPTH), fetuin-A, high-sensitivity C-reactive protein (hsCRP), albumin, homocysteine, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides and femoral neck bone mineral density were also measured. No differences were observed in patient distribution across the CACS risk categories between the two groups. Significant differences were observed in serum calcium, phosphate, 25(OH)D, alkaline phosphatase, iPTH, fetuin-A, hsCRP, homocysteine and triglycerides between the two patient groups. Further research into the diverse, numerous and often interlinked factors that influence CAC in different groups of patients is warranted.     

Adiponectin levels and atherosclerotic risk factors in pediatric chronic peritoneal dialysis patients.

BACKGROUND: Atherosclerotic vascular diseases are the major cause of mortality in patients with end-stage renal disease (ESRD) treated with chronic peritoneal dialysis (CPD), even in children. Adiponectin (ADPN) is a recently discovered adipocyte-derived plasma protein having anti-atherogenic properties. ADPN levels are elevated in ESRD but it has been reported that ESRD patients with low plasma ADPN levels have a high risk of cardiovascular death. OBJECTIVE: To clarify the atherosclerotic risk and especially the significance of ADPN levels in pediatric patients on CPD. DESIGN: Cross-sectional studyin the pediatric peritoneal dialysis unit of a university hospital. PATIENTS: 18 children, aged 12.6 +/- 5.6 years, being treated with CPD and 20 healthy age- and sex-matched control subjects were enrolled in this study. METHODS: Serum ADPN levels and other risk factors, including blood pressure, blood glucose, serum lipid/lipoprotein fractions, apolipoprotein B, C-reactive protein (CRP), lipoprotein(a), and homocysteine levels, were studied in CPD patients and compared to the controls. RESULTS: Serum ADPN levels were three times higher in the CPD group compared to the control subjects, as was previously reported. Apolipoprotein B and CRP levels were also high in the CPD group. No significant difference was found in other atherosclerotic parameters, including lipoprotein(a) and homocysteine levels. Interestingly, we found a negative correlation between log ADPN and creatinine levels among the CPD patients (r = -0.54, p < 0.05). There was no correlation between log ADPN and duration of CPD. Creatinine and low-density lipoprotein levels could account for 54% of the total variation in ADPN levels. CONCLUSION: Among pediatric CPD patients, serum levels of the anti-atherogenic protein, ADPN, were inversely associated with creatinine. ADPN level might be a novel marker to predict prognosis in pediatric CPD patients.     

血清Lp-PLA2、hs-CRP、D-二聚体水平与冠心病患者病情的相关性分析

[目的]探讨血清脂蛋白相关磷脂酶A2(Lp-PLA2)、超敏C反应蛋白(hs-CRP)、D-二聚体水平与冠心病患者病情的相关性.[方法]选取2018年10月至2019年5月本院收治的100例冠心病患者为研究对象,并根据患者的病情严重程度分为急性心肌梗死组、稳定型心绞痛组和不稳定型心绞痛组,同时选取同期在本院体检的健康志...     

冠心病患者C反应蛋白和可溶性细胞间粘附分子-1的测定及意义

目的:通过测定冠心病患者的血清C反应蛋白(CRP)和可溶性细胞间粘附分子-1(sICAM-1)水平,探讨CRP及sICAM-1在冠心病发病中的作用。方法:将73例冠心病患者分成稳定型心绞痛(SAP)组(n=20)、不稳定型心绞痛(UAP)组(n=25)、急性心肌梗塞(AMI)组(n=28),并将SAP组定义为非活动性冠心病组,UAP和AMI组定义为活动性冠心病组;对照组为健康体检者(n=20);分别测定其血清CRP、sICAM-1、肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)水平。结果:(1)冠心病患者的血清CRP、sICAM-1水平均有增高(P<0.05),且活动性冠心病组CRP、sICAM-1的水平显著高于非活动性冠心病组(P<0.01)。(2)AMI组患者血清CK、CK-MB浓度明显增高,与对照组比较有显著性差异(P<0.01);AMI组患者的CRP、sICAM-1水平分别与CK-MB浓度呈正相关(r=0.678,P<0.01;r=0.643,P<0.01)。结论:炎症参与了冠心病发病的整个过程,而CRP及sICAM-1在此炎症过程中起着重要的作用。     

Serum levels of nitric oxide end products and interactions with lipoproteins in patients with coronary artery disease

The purpose of this study was to examine whether the serum levels of nitric oxide end products and the ratio of nitrite to lipoproteins are valid instruments in the clinical follow-up of patients with coronary artery disease. 65 subjects were divided into three groups, including patients with coronary artery disease, silent coronary artery disease and controls. The serum nitrite level and also the ratio of nitrite to high-density lipoprotein were significantly different between the groups. According to the number of obstructed arteries, the serum nitrite level and the ratio of nitrite to high-density lipoprotein were found statistically different between the groups. There was a positive correlation between the serum nitrite level and the ratio of nitrite to high-density lipoprotein and the number of obstructed arteries. In conclusion, the serum nitrite level and ratio of nitrite to high-density lipoprotein may provide a beneficial guide to follow-up the status of patients with coronary artery disease.     

Concentration of Lp(a) and other apolipoproteins in predialysis, hemodialysis, chronic ambulatory peritoneal dialysis and post-transplant patients.

Serum levels of lipids, lipoprotein(a) Lp(a) and other apolipoproteins were determined in 47 predialysis patients, 40 hemodialysis (HD) patients, 39 chronic ambulatory peritoneal dialysis (CAPD) patients, 11 patients after kidney transplantation and 47 healthy subjects as reference group. The predialysis, HD, and CAPD patients had disturbances in the concentration of serum triglyceride (TG), high density lipoprotein (HDL)-cholesterol, apolipoprotein AI (apoAI), total apoCIII, apoCIII present in the particles without apoB (apoCIII non B), and Lp(a) and HDL-cholesterol, low density lipoprotein (LDL)-cholesterol/HDL-cholesterol, HDL-cholesterol/apoAI, apoAI/apoB, and apoAI/apoCIII ratios. Predialysis patients had significantly lower concentrations of HDL-cholesterol and total apoE levels than CAPD patients and total apoE level than HD patients. Moreover, both HD and CAPD patients had significantly increased levels of apoB containing apoE (apoB:E) and apoB containing apoCIII (apoB:CIII). The concentrations of serum TG, total cholesterol, LDL-cholesterol, apoB, Lp(a) in CAPD patients were statistically higher than in HD patients. The patients after transplantation demonstrated normalization of lipid and lipoprotein parameters and lipoprotein ratios except serum levels of TG, total apoCIII, apoCIII non B and the apoAI/apoCIII ratio. We concluded that abnormal lipid and lipoprotein concentrations in patients with uremia may be the cause of their high risk of atherosclerosis, but posttransplant patients exhibited improved levels of serum lipids, Lp(a) and other lipoprotein parameters and lipoprotein composition, which could be an index of decreased atherogenic status.     

冠心病患者CRP、SAA、PCT、IL-6水平与冠状动脉粥样硬化的相关性研究

目的观察冠心病患者冠状动脉粥样硬化发生情况,分析血清C反应蛋白(CRP)、血清淀粉样蛋白A(SAA)、降钙素原(PCT)、白细胞介素-6(IL-6)水平与冠状动脉粥样硬化的相关性。方法选择该院2017年3月至2019年3月收治的60例冠心病患者作为研究组,参照Gensini积分评分标准评估冠心病患者冠状动脉粥样硬化程度,根据Gensini积分将研究组患者分为轻度硬化组、中度硬化组及重度硬化组。另选择同期于该院接受健康体检的30例健康者作为健康对照组。检测全部研究对象血清CRP、SAA、PCT、IL-6水平,分析冠心病患者血清生化指标水平与冠状动脉粥样硬化的相关性。结果60例冠心病患者均存在不同程度的冠状动脉粥样硬化,轻度硬化、中度硬化、重度硬化患者分别为21、19、20例。重度硬化组血清CRP、SAA、PCT、IL-6水平高于中度硬化组、轻度硬化组、健康对照组(P<0.05),中度硬化组以上指标水平高于轻度硬化组、健康对照组(P<0.05),轻度硬化组以上指标水平高于健康对照组(P<0.05)。Pearson相关分析显示,冠心病患者Gensini积分与血清CRP、SAA、PCT、IL-6水平呈正相关(r=0.905、0.857、0.828、0.827,P<0.05)。结论冠心病患者血清CRP、SAA、PCT、IL-6水平随着冠状动脉粥样硬化程度的加重而升高,以上指标可能参与了冠心病患者冠状动脉粥样硬化的发生、发展,可考虑将其用于冠心病患者早期冠状动脉粥样硬化的评估,指导疾病的早期防控与治疗。     

CT血管造影联合血清同型半胱氨酸、脂蛋白(a)及B型脑钠肽在评估冠状动脉硬化狭窄中的临床价值

目的  探讨CT血管造影联合血清同型半胱氨酸（Hcy）、脂蛋白（LP）(a) 及B型脑钠肽（BNP）在冠状动脉硬化狭窄中的评估价值。方法  选取我院2020年12月~2021年7月收治的150例冠心病患者作为观察组,另选取86例健康体检者作为对照组,均予以CT血管造影及血清Hcy、BNP、LP(a)水平检查,分析上述血清指标与疾病类型、冠脉病变支数、冠脉狭窄程度、斑块性质及CT血管造影冠脉参数的相关性。结果  观察组血清Hcy、BNP、LP(a)水平及斑块负荷、血管狭窄程度、重建指数（RI）较对照组更高,血管体积低于对照组（P < 0.05）;急性心肌梗死患者血清Hcy、LP(a)、BNP水平及斑块负荷均 > 不稳定型心绞痛患者 > 稳定型心绞痛患者 > 隐匿型冠心病患者（P < 0.05）;随冠脉病变支数、冠脉狭窄程度增加,冠心病患者上述血清指标升高,斑块负荷、RI值均增加（P < 0.05）;非钙化斑块者上述血清指标及斑块负荷、血管狭窄程度、RI值高于钙化斑块者（P < 0.05）;冠心病患者3项血清指标均与非钙化斑块及斑块负荷、急性心肌梗死、冠脉病变支数、冠脉狭窄程度、血管狭窄程度、RI值呈正相关（P < 0.05）;ROC曲线显示,CT血管造影联合3项血清指标诊断冠状动脉硬化重度狭窄（狭窄程度 > 75%）的敏感度、特异性、曲线下面积分别为0.81、0.82、0.878。结论  冠心病患者血清Hcy、LP(a)、BNP水平逐渐升高,与CT血管造影参数联合可较好地诊断冠状动脉硬化狭窄程度。     

血清脂联素水平与冠脉病变程度及炎症标志物变化的关系

目的探讨血清脂联素水平与冠脉病变严重程度及炎症标志物变化的关系。方法对176例可疑冠状动脉粥样硬化性心脏病（简称冠心病）患者行冠状动脉造影检查并检测其血清脂联素及超敏C-反应蛋白（hs-CRP）、肿瘤坏死因子-α（TNF—α）、白介素-6（IL-6）、可溶性E-选择素（sE—s）、可溶性细胞间黏附分子-1（sICAM-1）水平，根据冠状动脉造影结果及冠脉病变的Gensini评分将患者进行分组，比较各组血清脂联素及炎症标志物水平的差异；用多元逐步回归筛选脂联素的影响因素。结果①冠心病患者血清脂联素水平明显低于正常对照组（P〈0．01），血清炎症标志物水平明显高于正常对照组（P〈0．05，P〈0．01）；②随着冠脉病变Gensini评分的增加血清脂联素水平逐渐降低（P〈0．05，P〈0．01），血清炎症标志物水平逐渐增高（P〈0．05，或P〈0．01）；③脂联素与高密度脂蛋白胆固醇呈正相关，与BMI、甘油三酯、hs-CRP、TNF—α、sICAM-1水平及冠脉病变Gensini评分呈负相关（P〈0．01）。结论冠心病患者血清脂联素水平降低，血清炎症标志物水平增高，低脂联素血症是冠脉病变严重程度的标志，脂联素具有抗炎、抗动脉粥样硬化作用。     

冠心病患者血清C反应蛋白与血管内皮损伤的关系

目的：探讨冠心病患者血清C反应蛋白与血管内皮损伤的关系。方法：以43例冠心病患者为研究对象,以17例其他心脏病患者和28例健康体检者为对照组,测定外周血循环内皮细胞数量及血清CRP水平。结果：冠心病患者组CEC数量[（7.2±3.1/0.9μl]和CRP水平[（4.63±1.88）mg/L]明显高于其他心脏病组和健康对照组（P〈0.01）。冠心病患者CEC数量和CRP水平呈正相关（r=0.621）。结论：冠心病患者的血管内皮损伤可能与CEC及CRP有关,二者的协同作用可能在动脉粥样硬化的发病机制中发挥重要作用。     

冠心病患者血尿酸及超敏C-反应蛋白检测及分析

[目的]探讨冠心病患者血尿酸（UA）及超敏C-反应蛋白（HS—CRP）检测的临床应用价值。[方法]对134例冠心病患者（试验组）和128名健康体检者（对照组）分别进行UA及HS—CRP的检测,并对结果进行比较分析。[结果]冠心病患者UA及HS—CRP水平均高于健康对照组,两者比较差异有统计学意义（P〈0．01）。[结论]冠心病患者UA及HS—CRP水平明显升高,联合检测UA及HS—CRP对冠心病的诊断、治疗和判断预后有重要的临床意义。