高敏C-反应蛋白、同型半胱氨酸、D-二聚体在冠心病病情严重程度评估中的应用

目的探讨高敏c-反应蛋白（hs—cRP）、同型半胱氨酸（Hcy）、D一二聚体（D—D）与冠心痛（CHD）病情严重程度的相关性。方法选取冠心痛患者164例，其中急性心梗（AMI）7l例，不稳定性心绞痛（UA）58例，稳定性心绞痛（SA）35例，并对uA患者进行Braunwald分级，对AMI患者进行KiUip分级．另选健康体检者40例为对照；对以上所有受试者采用免疫散射比浊法检测hs—CRP的含量，采用循环酶法检测Hcy，采用增强免疫比浊法检测血浆D—D，并进行统计学分析。结果冠心病患者hs—CRP、Hey、D—D均显著高于正常对照组（P〈0．01），且AMI组〉uA组〉SA组；hs—CRP、Hey、D—D与疾病严重程度存在良好的相关性：随着Braunwald分级增高，uA患者hs—CRP、Hey、D—D逐渐升高，Hey、D—D三级问每两者之间的的差异均有统计学意义（P〈0．05）；随着KiUip分级增高。AMI患者血清hs—CRP、Hey、D—D也逐渐逐渐升高，Hey、D—D三级间每两者之间的的差异均有统计学意义（P〈0．05）；AMI组和uA组的hs—cI蹬、Hcy、D—D明显高于sA组（P〈0．05）。结论hs—cRP、Hcy、D—D与冠心病的严重程度存在良好的相关性，常规检测hs—CRP、Hcy、D—D时冠心病的辅助诊断及其病情严重程度的评估有一定的临床意义，并能早期预测急性冠脉综合症（hCS）危急事件的发生。

The application of hs-CRP, Hcy and D-D in the severity evaluation among the patients with coronary heart disease

Objective To Explore whether high sensitive C - reactive protein（hs - CRP）, homocysteine （Hcy） and D - dimers （D - D） in patients with coronary heart disease （CItD） correlated with severity of the diseases. Methods Control group 40 cases and patients with coro- nary artery disease 164 cases including an acute myocardial infarction （AMI） 71 cases, unstable angina pectoris （UA） 58 cases, and stable angina （SA） 35 cases were collected, patients at UA and AMI were were separated into 3 groups by Braunwald classes and Killip classes. Serum hs- CRP, Hey and plasma D - D levels at all participants were measured by by immune scattering method, Circulation enzymatic method and enhance immune turbidity method, respectively, and data was analyzed statistically. Results ： The hs - CRP, Hey, and D - D lev- els in patients with coronary artery disease were significantly higher than normal group （ P 〈 0.05）, and AMI group 〉 SA group 〉 UA group ; The hs- CRP, Hey and D- D levels in patients with CHD was dramatically back correlative with the severity of the diseases：with the upgrad- ing of Braunwald classes, The hs - CRP, Hey and D - D levels in patients with UA increasing gradually with the upgrading of Killip classes;the differences of Hey, D - D at AMI and UA amony level 3 are statistically significant （P 〈 0.05） ; The hs - CRP, Hey and D - D levels at AMI group and UA group was obviously higher than that at SA group （P 〈 0.05）. ConclusionThe hs- CRP, Hey, D- D leveIs exist good correla- tion with coronary heart disease severity;Conventionally detecting hs - CRP, Hey and D- D levels has certain clinical significance for assistant diagnosis of CHD and evaluation of the degree of severe disease, and can predict early ACS critical events.