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目的分析血清淀粉样蛋白A(SAA)与老年冠心病患者冠状动脉病变严重程度的相关性。方法选择2014年6月~2015年6月在我院接受住院治疗的168例胸痛患者,其中男性85例,女性83例,年龄60~82(68.21±5.61)岁。所有入选的胸痛患者均行冠状动脉造影术,根据冠状动脉造影的结果分为冠心病组121例和非冠心病(non-CHD)组47例。冠心病组根据其亚型又分为:稳定性心绞痛(SAP)组36例、不稳定性心绞痛(UAP)组48例、急性心肌梗死(AMI)组37例。所有患者根据是否行PCI术分为PCI组100例,non-PCI组68例。采用ELISA法检测SAA水平,Gensini评分评价冠状动脉病变的严重程度。结果冠心病组患者血清SAA水平明显高于nonCHD组患者[(139.20±87.42)mg/L vs(31.69±6.69)mg/L,P=0.005]。AMI组及UAP组的血清SAA水平明显高于SAP组和non-CAD组[(224.11±91.98)mg/L及(135.80±42.82)mg/L vs(56.46±18.98)mg/L和(31.69±6.69)mg/L],且AMI组明显高于UAP组。相关分析显示,血清SAA水平与LDL-C呈负相关(r=-0.081,P=0.040),总体血清SAA水平与Gensini评分呈正相关(r=0.489,P=0.000)。PCI组患者术后7d血清SAA水平较术前明显下降(P<0.05)。结论老年冠心病患者血清SAA水平与冠状动脉病变严重程度呈正相关。
Objective To analyze the relationship between serum amyloid A (SAA) and the severity of coronary artery disease in elderly patients with coronary heart disease. Methods Sixty-six patients with chest pain who were hospitalized in our hospital from June 2014 to June 2015 were selected, 85 males and 83 females, aged 60-82 years (68.21 ± 5.61) years. All patients with chest pain underwent coronary angiography. According to the results of coronary angiography, they were divided into coronary heart disease group (n = 121) and non-coronary heart disease group (n = 47). According to its subtype, coronary heart disease group was divided into three groups: 36 cases in SAP group, 48 cases in UAP group and 37 cases in AMI group. All patients were divided into PCI group (100 cases) and non-PCI group (68 cases) according to whether PCI was performed or not. The level of SAA was detected by ELISA and the severity of coronary artery disease was assessed by Gensini score. Results Serum SAA levels in CHD patients were significantly higher than those in nonCHD patients [(139.20 ± 87.42) mg / L vs (31.69 ± 6.69) mg / L, P = 0.005]. Serum SAA levels in AMI group and UAP group were significantly higher than those in SAP group and non-CAD group [(224.11 ± 91.98) mg / L vs (135.80 ± 42.82) mg / L vs (56.46 ± 18.98) mg / L vs 6.69) mg / L], and the AMI group was significantly higher than the UAP group. Correlation analysis showed that there was a negative correlation between serum SAA level and LDL-C (r = -0.081, P = 0.040). There was a positive correlation between total serum SAA level and Gensini score (r = 0.489, P = 0.000). Serum SAA levels in PCI group decreased significantly at 7 days after operation (P <0.05). Conclusion The level of serum SAA in elderly patients with coronary heart disease is positively correlated with the severity of coronary artery disease.