冠心病患者颈动脉超声检测与血浆hsCRP、D-dimer关系的探讨

目的研究冠心病患者冠心病颈动脉斑块及血hs-CRP、D-dimer水平的相关性。方法收集临床诊断冠心病患者80例,非冠心病对照组30例。冠心病组又分为急性心肌梗死、不稳定性心绞痛、稳定性心绞痛三个亚组。超声探测各组颈动脉IMT、Crouse积分;并检测血浆hsCRP、D-dimer水平;所得数据进行统计分析。结果①冠心病组IMT、Crouse积分、hsCRP、D-dimer浓度均高于对照组,差异有统计学意义(P<0.01)。②冠心病组三个亚组中IMT,Crouse积分差别无统计学意义(P>0.05)。SAP组、UAP组、AMⅠ组的hsCRP水平依次升高,差别具有统计学意义(P<0.05);与SAP组比,UAP组、AMⅠ组患者血D-dimer浓度显著升高,有显著差异(P<0.05);与UAP组比较,AMⅠ组hsCRP明显高于UAP组(P<0.05),D-dimer无显著性差异(P>0.05)。③经直线相关分析,D-dimer、hsCRP浓度分别与IMT及Grouse积分呈正相关;血浆D-dimer同时与hs-CRP有较好的相关性,相关系数为r=0.682,(P<0.05)。结论颈动脉超声检查,有助于识别冠心病高危患者。hsCRP、D-dimer是反映斑块的稳定性的可靠指标。颈动脉超声结合hsCRP、D-dimer检测,对冠心病患者不同缺血状态有一定的诊断价值。

Investigation about the relationship between carotid artery ultrasound and plasma hsCRP, D-dimer in patients who had coronary artery disease

Objective To investigate the relationship with carotid artery plaque and hsCRP, D-dimer in patients who had coronary artery disease（CAD）. Methods 80 cases who were diagnosed with CAD were collected, and 30 cases who had no CAD were regarded as the control group. CAD group was divided into three subgroups, they were acute myocardial infarction （AMI） subgroup, unstable angina pectoris （UAP） subgroup and stable angina pectoris （SAP） subgroup. Detect bilateral carotid artery IMT, Crouse score by ultrasound, and plasma levels of hsCRP and D-direct in patients were also detected. The data obtained were analyzed using statistical methods. Results （1）IMT, hsCRP and D-dimer in the control group were remarkable difference with CAD groups （P 〈 0. 05 ）. （2）There were no notable difference in IMT, Crouse score in the three subgroups of CAD （P 〉 0. 05）. In SAP group, UAP group and AMI group, hsCRP levels increased successively, the statistical difference was significant （ P 〈 0. 05 ）. Compared with SAP group, the D-dimer in UAP and AMI group were ap- parently increased, a significant difference （P 〈 0. 05）. The level of hsCRP in AMI group was higher than in UAP group （P 〈 0.05 ）, but D-dimer in the two groups were no significant difference （P 〉 0. 05 ）. （3）By linear correlation analysis, D-dimer, hs-CRP was positively correlated with the IMT and Grouse score. There was a good correlation between D-dimer with hsCRP, the correlation coefficient r = 0. 682 （P 〈 0.05 ）. Conclusion By carotid ultrasound, high-risk CAD patients can be identified, which conducive to the secondary prevention in CAD patients. D-dimer and hsCRP are reliable dicators which can reflect the plaque stability in CAD patients. There are certain diagnostic value in different ischemia state in CAD patients by detecting hsCRP, D-dimmer and carotid ultrasound.