急性冠脉综合征患者LPA hs-CRP和HCY水平的临床研究

摘要

目的 探讨溶血磷脂酸(LPA)、超敏C-反应蛋白(hs-CRP)、同型半胱氨酸(HCY)在急性冠脉综合征(ACS)发生、发展中的意义.方法 100例ACS患者分为急性心肌梗死(AMI)组48例和不稳定型心绞痛(UAP)组52例,另选健康体检者55例作为对照组.所有入选者抽静脉血测定LPA、hs-CRP和HCY的水平;对ACS患者的冠脉病变进行Gensini评分.比较各组间检测指标的差异;分析检测3个指标与Gensini评分的相关性及指标之间的相关性.结果 ACS组(包括AMI组和UAP组)血清LPA、hs-CRP、HCY水平均明显高于对照组(P＜0.01);AMI组血清LPA、HCY和hs-CRP水平较UAP组升高(P＜0.05和P＜0.01);AMI组比UAP组Gensini评分高(P<0.01);ACS组3个检测指标水平与Gensini评分均成正相关;ACS组LPA水平与hs-CRP水平成正相关、hs-CRP水平与HCY水平成正相关、LPA水平与HCY水平无相关性.结论 LPA、hs-CRP、HCY水平与ACS的发生、发展有着密切的关系,它们与冠状动脉病变程度密切相关.三者均可作为ACS发病及判断其严重程度的重要血清标志物.%Objective To investigate the significance of lysophosphatidic acid(LPA) , high -sensitivity C reactive protein( hs - CRP) , homocysteine ( HCY) in the occurrence and development of acute coronary syndrome( ACS) . Methods 100 patients with ACS were divided into two groups, group 1 : AMI (re =48) , group 2: UAP (re =52). we also chose a group of healthy volunteers as control group ( re =55) . All the objects were taken the exsanguinate assay, examination of the LPA, the hs - CRP and the HCY. The lesions of coronary arteries were assessed and analyzed by Gensini score in all ACS patients. Compare the difference level of LPA, hs - CRP and HCY between each group. The correlation in level of LPA, hs -CRP and HCY in serum with Gensini score were analyzed. The relevance among the level of LPA, hs - CRP and HCY in serum were also analyzed. Results In contrast with the control group, the serum levels of LPA, hs - CRP and HCY in ACS (including AMI and UAP) patients was increased obviously(P < 0. 01) , the serum levels of LPA, HCY and hs - CRP in AMI patients was higher than those in UAP patients (P < 0. 05 and P < 0. 01 ) , the Gensini score of AMI patients was higher than that of UAP patients( P < 0. 01 ). The serum levels of LPA, hs - CRP and HCY in ACS patients was directly correlated with Gensini score respectively. In ACS group, there are positive correlation between LPA and hs - CRP, also positive correlation between hs - CRP and HCY, while no correlation between LPA and HCY. Conclusion The serum levels of LPA, hs - CRP and HCY are closely correlated with the occurrence and development of ACS. They are closely related to the lesions of coronary arteries. LPA, hs - CRP and HCY was an important serum maker of the attack and serve degree of ACS respectively.