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目的分析不同类型冠心病患者血清中超敏C反应蛋白(hs-CRP)、B型脑钠肽(BNP)以及脂联素(APN)含量的变化及三者之间的相关性。方法选取冠心病患者110例作为研究对象,按照患者的疾病类型划分急性心肌梗死(AMI)组35例,不稳定心绞痛(UAP)组38例,稳定型心绞痛(SAP)组37例,并选取同期于医院体检的健康志愿者35名作为对照组。于入院次日清晨采集受试者静脉血,分别检测血清中hs-CRP、BNP及APN含量。结果SAR组hs-CRP水平与对照组比较无统计学差异(P>0.05),其余各组hs-CRP水平两两比较均有显著性差异(P<0.05);AMI组与UAP组血清BNP及APN水平比较差异无统计学意义(P>0.05),其余各组BNP及APN水平两两比较差异有统计学意义(P<0.05)。不同病变组hs-CRP水平比较差异无统计学意义(P>0.05);各组BNP水平两两比较均有显著性差异(P<0.05);双支和三支血管病变组患者APN水平均显著低于单支组(P<0.05),双支病变组和三支病变组APN水平比较差异无统计学意义(P>0.05)。冠心病患者血清中hs-CRP水平与BNP呈正相关(r=0.298,P<0.01);hs-CRP水平与APN水平呈负相关(r=-0.406,P<0.01);BNP与APN呈负相关(r=-0.239,P<0.01)。结论hs-CRP、BNP及APN血清含量与冠心病密切相关,可通过联合检测三者含量对冠心病发病及病变程度进行预测。
Objective To analyze the changes of serum hs-CRP, BNP and APN in patients with different types of coronary heart disease (CHD) and their correlations. Methods A total of 110 patients with coronary heart disease (CHD) were enrolled in this study. 35 cases were divided into acute myocardial infarction (AMI) group, 38 cases with unstable angina pectoris (UAP) and 37 cases with stable angina pectoris (SAP) Thirty-five healthy volunteers in the hospital were taken as the control group. Venous blood was collected from the subjects on the morning of admission, and serum levels of hs-CRP, BNP and APN were measured respectively. Results The levels of hs-CRP in SAR group were not significantly different from those in control group (P> 0.05), while the levels of hs-CRP in other groups were significantly different (P <0.05) There was no significant difference in the level of APN between the two groups (P> 0.05). There was significant difference in BNP and APN between the other groups (P <0.05). There was no significant difference in hs-CRP levels in different pathological groups (P> 0.05); BNP levels in each group were significantly different between two groups (P <0.05); APN levels in both groups were significantly higher (P <0.05). There was no significant difference in APN levels between the two-vessel disease group and the three vessel disease group (P> 0.05). The level of hs-CRP in serum of patients with coronary heart disease was positively correlated with BNP (r = 0.298, P <0.01), while the level of hs-CRP was negatively correlated with APN (r = -0.406, P <0.01) (r = -0.239, P <0.01). Conclusion The serum levels of hs-CRP, BNP and APN are closely related to coronary heart disease. The incidence of coronary heart disease and the degree of the disease can be predicted by the combined detection of the three levels.