脂蛋白(a)、纤维蛋白原和高敏C反应蛋白联合检测在冠心病诊断中的应用价值

目的探讨脂蛋白(a)、纤维蛋白原和高敏C反应蛋白联合检测对冠心病的诊断价值。方法对166例疑诊冠心病的患者进行冠状动脉造影检查,根据造影结果分为冠心病组和非冠心病组,收集2 mL抗凝全血标本,分离血浆,采用免疫比浊法,将同一标本同时在日立7170全自动生物化学分析仪测定脂蛋白(a)、纤维蛋白原和高敏C反应蛋白三个指标。结果冠心病组脂蛋白(a)、纤维蛋白原和高敏C反应蛋白测定值均显著高于非冠心病组(P<0.01);单个指标脂蛋白(a)、纤维蛋白原和高敏C反应蛋白诊断冠心病的灵敏度依次为脂蛋白(a)(73.9%)>高敏C反应蛋白(63%)>纤维蛋白原(56.5%),特异性为高敏C反应蛋白(86.5%)>纤维蛋白原(75.7%)>脂蛋白(a)(70.3%)。三项指标联合检测对冠心病患者诊断的特异度(91.9%)高于分别应用脂蛋白(a)(70.3%)、纤维蛋白原(75.7%)和高敏C反应蛋白(86.5%)单一指标。结论联合应用脂蛋白(a)、纤维蛋白原和高敏C反应蛋白进行检测,能更准确诊断冠心病的发生,这为建立一种集成检测来提高对心脑血管疾病诊断的新方法提供了理论依据。

The Value of Plasma Lipoprotein(a),Fibrinogen and High-sensitivity C-Reactive Protein in the Diagnosis of Coronary Heart Disease

Aim To study the value of detecting plasma lipoprotein(a)(Lp(a)),fibrinogen(Fig)and high-sensitivity C-reactive protein(hs-CRP)in the anticipation and diagnosis of coronary heart disease(CHD). Methods 166 suspected cases of CHD undergone coronary arteriongraphy were classified into CHD group and nonCHD group.All the subjects were drawn 2mL peripheral blood.And the plasma samples were segregated.Lp(a),Fig and hs-CRP were evaluated and analyzed in both of these two groups. Results The concentration of Lp(a),Fig and hs-CRP was significantly higher in CHD patients than that in the nonCHD subjects(P<0.01).The sensitivity of the markers of Lp(a),hs-CRP and Fig were 0.739,0.63 and 0.565 respectively.The specificity of detecting all the three markers(0.919)was higher than that of single marker detecetion of either Lp(a)(0.703)or Fig(0.757)or hs-CRP(0.865). Conclusion Combined detection of three markers of Lp(a),Fig and hs-CRP may help improve the anticipation and diagnosis of CHD.