血清胱抑素C水平对冠心病的诊断价值

摘要

Objective To analyze the diagnostic value of serum Cys-C level on coronary heart disease. Methods A total of 416 suspected coronary heart disease patients were selected in the people′s Hospital of Tongling from June 2012 to June 2015,and they were divided into control group( did not diagnosed as coronary heart disease,n = 164) and case group (diagnosed as coronary heart disease,n = 252) according to coronary angiography examination results,thereinto 88 patients diagnosed as stable angina pectoris were served as A group,126 patients diagnosed as non ST - segment elevation acute coronary syndrome were served as B group,38 patients diagnosed as ST - segment elevation myocardial infarction were served as C group. General information of control group and case group were recorded after admission,serum Cys-C level was detected by latex immune turbidimetry at admission and 7 days after admission,respectively,ROC curve was drew to evaluate the diagnostic value of serum Cys-C level(at admission)on stable angina pectoris. Results No statistically significant differences of age,BMI, positive rate of smoking history,of dyslipidemia,positive rate of coronary heart disease history or eGFR was found between control group and case group(P > 0. 05),while the proportion of male,positive rates of diabetes and hypertension of case group were statistically significantly higher than those of control group( P < 0. 05). Serum Cys-C level at admission of A group was statistically significantly higher than that of control group,B group and C group,respectively;serum Cys-C level after 7 days of admission of A group,of B group,of C group was statistically significantly higher than that of control group,respectively(P <0. 05). Multivariate logistic regression analysis showed that,serum Cys-C level after 7 days of admission was an independent risk factor of coronary heare disease〔OR = 3. 725,95% CI(1. 248,11. 119),P < 0. 05〕. ROC curve showed that,the AUC of serum Cys-C level(at admission)was 0. 805〔95% CI(0. 674,0. 937)〕in the diagnosis of stable angina pectoris,when it was 1. 015 mg/ L,the sensitivity was 80. 2% ,the specificity was 72. 0% . Conclusion Serum Cys-C level of patients with acute coronary syndrome does not significantly changed,while serum Cys-C level of patients with stable angina pectoris is significantly elevated at admission,it has certain diagnostic value in the diagnosis of stable angina pectoris.%目的：分析血清胱抑素 C（Cys-C）水平对冠心病的诊断价值。方法选取铜陵市人民医院2012年6月—2015年6月收治的因疑似冠心病入院治疗患者416例，根据冠状动脉造影结果将患者分为冠心病组252例和非冠心病组164例。冠心病患者中稳定型心绞痛（SAp）88例（SAp 组）、非 ST 段抬高急性冠脉综合征（ NST-ACS）126例（NST-ACS组）、ST 段抬高型心肌梗死（STEMI）38例（STEMI 组）。记录冠心病组和非冠心病组患者的一般资料，分别在入院时和入院7 d 后采用乳胶免疫比浊法检测血清Cys-C水平，并绘制 ROC 曲线评价入院时血清Cys-C水平对SAp 的诊断价值。结果冠心病组与非冠心病组患者年龄、体质指数、吸烟史阳性率、血脂异常史阳性率、冠心病病史阳性率及估算肾小球滤过滤（eGFR）比较，差异无统计学意义（ P >0.05）；冠心病组患者男性所占比例、糖尿病及高血压病史阳性率均高于非冠心病组（P <0.05）。入院时 SAp 组患者血清Cys-C水平高于非冠心病组、NST-ACS组和STEMI 组，入院7 d 后 SAp 组、NST-ACS组和 STEMI 组患者血清Cys-C水平高于非冠心病组（P <0.05）。多因素 logistic回归分析结果显示，治疗7 d 后血清Cys-C水平是冠心病的独立危险因素〔OR =3.725，95% CI（1.248，11.119），P <0.05〕。绘制入院时血清Cys-C水平诊断 SAp 的 ROC 曲线，结果显示，当血清Cys-C为1.015 mg/ L 时，其诊断 SAp 的特异度和灵敏度最高，分别为72.0%和80.2%，曲线下面积为0.805〔95% CI（0.674，0.937）〕。结论 ACS 患者急性期血清Cys-C水平无明显变化，SAp 患者入院时血清Cys-C水平即已升高，且血清Cys-C水平对 SAp 具有一定的诊断价值。