高敏C反应蛋白、脂蛋白a、血尿酸与冠状动脉病变程度的相关性

目的 探讨高敏C反应蛋白(hs-CRP)、脂蛋白a、血尿酸(UA)等指标与冠状动脉病变程度的关系.方法 收集我院2005年1月至2009年4月拟诊或确诊为冠心病患者813例,入选对象行选择性冠状动脉造影后,根据造影结果是否有冠状动脉狭窄≥50%分为冠心病组和非冠心病组(对照组).对冠心病组进一步根据冠状动脉病变的支数分为1～4支病变组.采用全自动生化分析仪检测hs-CRP、脂蛋白a、血尿酸水平.结果 冠心病组754例,对照组59名.冠心病组和对照组比较,hs-CRP:(7.12±4.48比1.71±1.42)mg/L、脂蛋白a:(0.45±0.42比0.18±0.03)mmol/L、血尿酸:(402±103比327±88)μmol/L均较对照组高,差异均有统计学意义(均P<0.05).1支病变组和4支病变组比较分别为hs-CRP:(3.59±2.93比13.11±3.00)mg/L、脂蛋白a:(0.37±0.25比0.58±0.17)mmol/L、血尿酸:(384±126比444+90)μmol/L,差异均有统计学意义(均P<0.05).Logistic回归分析结果表明血清hs-CRP、脂蛋白a、血尿酸为冠心病的独立危险因素.结论 血清hs-CRP、脂蛋白a、血尿酸增高对冠心病的发生发展有促进作用,联合检测hs-CRP、脂蛋白a、血尿酸水平对评价冠心病高危人群及患者病情具有临床应用价值.

Correlation between high sensitive C-reactive protein, lipoprotein(a), blood uric acid and severity of coronary artery disease

Objective To discuss the relationship between high sensitive C-reactive protein (hs-CRP), lipoprotein (Lp)(a), blood uric acid (BUA) and severity of coronary artery disease (CHD).Methods A total of 813 cases of suspected or established coronary atherosclerotic heart disease patients were recruited.The patients received selective coronary arteriography and they were divided into normal and CHD groups according to the result of selective coronary arteriography.The dividing mark was coronary artery stenosis more than 50% by selective coronary arteriography.Patients in CHD group were further divided into 1-4 vessel disease.Blood glucose, cholesterol, triglyceride, LDL-ch, hs-CRP and BUA were detected by automatic biochemical analyzer.Results Among them, 754 cases ( CHD group, 92.7% ) were confirmed as coronary heart disease while 59 cases( control group, 7.3% )confirmed as non-coronary heart disease.There were significantly difference between two groups ( P < 0.05 ) : hs-CRP ( 7.12 ± 4.48 vs1.71 ± 1.42) mg/L, Lp (a) (0.45 ± 0.42 vs 0.18 ± 0.03 ) mmol/L and BUA (402 ± 103 vs 327 ± 88 )μmol/L.The levels of hs-CRP, Lp (a) and BUA in different number of diseased coronary vessels significantly differed from each other ( P < 0.05 ).A comparison of 1-vessel disease group versus 4 vessel disease group was as follows: hs-CRP (3.59 ± 2.93 vs 13.11 ± 3.00) mg/L, Lp(a) (0.37 ± 0.25 vs0.58 ±0.17) mmol/L and BUA (384 ± 126 vs 444 ±91 ) μmoL/L.Logistic regression analysis showed that hs-CRP, Lp(a) and BUA were independent risk factors of coronary artery disease.Conclusions The elevations of hs-CRP, LP (a) and BUA promote the establishment and development of coronary artery disease.A joint detection of hs-CRP, Lp(a) and BUA shows a comparatively great value in evaluating highrisk groups and the patient's condition.And it provides references for an active intervention of clinical coronary heart disease.