胱抑素C及D二聚体与冠心病病变程度相关性研究

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。

Correlation of cystatin C and D-dimer with the lesion extent of coronary heart disease

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 ?