17-OH、17-KS、VMA、ALD和COR在心血管疾病中的诊断价值

目的：探讨尿17羟皮质类固醇（17-OH）、17酮皮质类固醇（17-KS）、香草扁桃酸（VMA）、血浆醛固酮（ALD）和血清皮质醇（COR）在心血管疾病中的水平变化及应用价值。方法：应用微柱比色法和电化学发光法对116例原发性高血压（PH）患者、52例继发性高血压（SH）患者和21例冠心病（CHD）患者进行24h尿液17．OH、17-KS、VMA和血浆ALD、血清COR的检测，以30例健康人作为正常对照组。结果：与正常对照组比较，SH组17．OH、17-KS、VMA、ALD和COR水平均较对照组和PH组增高，具统计学意义（P〈0．01，P〈0．001）；CHD组尿17-OH、17．OH和血浆ALD、血清COR水平较正常对照组明显增高，具统计学意义（P〈0．01，P〈0．05）；相关实验显示，ALD与17-OH、17-KS之间呈正相关（r=0．502、0．796，P〈0．01）；COR与17-OH、17-KS之间亦呈正相关（r=0．648、0．584，P〈0．01）；ALD、COR与VMA之间无相关性（P〉0．05）。结论：尿17．OH、17-KS、VMA、血浆ALD、血清COR水平联检在PH和SH的鉴别诊断、针对性治疗和CHD的预后判断等方面具有重要临床价值。

The Clinical Value of 17-OH, 17-KS,VMA, ALD and COR in the Diagnosis of Cardiovascular Diseases

Objective Discussion on 17-OH, 17-KS, VMA, ALD and COR levels in cardiovascular disease and its applicative value. Methods With micro column chro~tography and dectrochemil-minescence as the method to detecte 24h urine 17-OH, 17- OH, VMA and plasma ALD, sermn COB levels in 116 patients with primary hypertension, 52 patients with secondary hypertension and 21 patients with coronary heart disease（CHD） ,30 cases of healthy people served as the normal control group. Results Compared with the control group,17-OH, 17-KS, VMA, ALD and COB levels expressed lower in secondary hypertension group than those in the con- trol group and hypertension group; 17-0H, 17-OH and ALD, COR levels showed significantly higher in CHD group than the control group（P 〈0.01, P 〈 0.05 ）; Related experiments show a positive correlation between ALD and urine 1%0H, 1% KS （r = 0. 502, 0.796 ,P 〈0.01 ） ; and a positive correlation between COB and urine 17-0H, 17- KS（r =0. 648,0. 584, P 〈0.01 ） ; there is no corre-lation between plasma ALD, serum COR and urine VMA （P 〉 0.05）. Conclusion Urine 17-OH, 17-KS, VMA, plasma ALD, serum COR as the combined detection, it provides important clinical values in differential diagnosis of primary, secondary hypertension for treatment and judging the prognosis of CHD.