目的 检测冠心病(CHD)患者血清游离脂肪酸(FFA)、脂蛋白a(Lpa)和超敏C反应蛋白(hs-CRP)的表达水平,探讨其在CHD发生、发展中的作用及其相关临床应用价值.方法 收集该院心内科住院并行冠状动脉造影检查确诊为冠心病的患者120例为CHD组,选取体检中心的健康体检者20例为正常对照(A)组.其中CHD组又分为单支病变(B)组、双支病变(C)组、多支病变(D)组.酶法检测血清FAA水平,免疫比浊法检测血清Lpa和hs-CRP.结果 FFA、Lpa、和hs-CRP在CHD患者中的水平显著高于正常对照组(P<0.01).B、C和D组中FFA、Lpa、和hs-CRP水平均显著高于A组(P<0.05),并且FFA、Lpa、和hs-CRP水平在B、C、D组之间存在显著性差异(P<0.05).FFA、Lpa、和hs-CRP的水平随着冠脉病变分支的增加而逐渐升高.结论 冠心病患者FFA、Lpa、和hs-CRP水平升高,联合检测FFA、Lpa和hs-CRP水平的变化可以较好地反映冠状动脉病变的严重程度.%Objective To investigate the changes of serum FFA,Lp(a) ,and hs-CRP in coronary atherosclerotic heart diease (CHD) patients and to explore its clinical significance. Methods A total of 120 patients with CHD were enrolled in this study. Another 20 healthy person were used as a normal control. All cases were divided into four groups: normal control (A) group, single-vessel ( B) group, double-vessel ( C ) group, and more than double-vessel ( D) group. The levels of serum FAA was measured with enzymic method analysis. The levels of serum Lp(a) and hs-CRP were measured with Latex enhanced immunoturbidimetric assay. Results The levels of serum FFA,Lp (a) ,and hs-CRP were higher in CHD group than those in normal control group (P 〈0. 01). The expressions of FFA,Lp(a) ,and hs-CRP were all higher in B,C,and D group than those in A group(P 〈0.05). There were significant differences of serum FFA,Lp(a) ,and hs-CRP among B,C,and D groups(P 〈0.05). The FFA,Lpa,and hs-CRP levels were gradually increased according to the degree of coronary lesions. Conclusions The high-level expressions of FFA, Lp( a) , and hs-CRP play a key role in the development of coronary atherosclerotic heart disease. The combined detection of serum FFA,Lp(a) ,and hs-CRP can be used to predict the extent of coronary atherosclerosis.
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