血清γ-谷氨酰基转移酶总活性在冠心病严重程度评估中的应用

摘要

目的：回顾性分析冠心病病变严重程度与血清γ‐谷氨酰基转移酶（GGT ）总活性相关指标之间的关系。方法测定465例不稳定性心绞痛（UA）患者，665例稳定性心绞痛（SAP）患者，126例冠状动脉造影结果阴性的对照组的GGT总活性（采用酶法）、血清同型半胱氨酸（Hcy ，采用循环酶法）、血清超敏C‐反应蛋白（hs‐CRP ，采用胶乳增强免疫比浊法），同时检测纤维蛋白原（FG ）。比较上述3组间的差异。所有造影结果阳性患者随访1年，并记录再次运行心脏事件（包括心肌梗死、死亡），分析GG T总活性与再次运行心脏事件之间的关系。结果 UA组GGT总活性[（43．74±18．78）U／L[]，显著高于SAP组[（30．13±11．43） U／L]，差异有统计学意义（P＜0．05）；UA组的 Hcy为（23．74±8．78）mol／L ，显著高于SAP组[（15．13±11．43）mol／L]，差异有统计学意义（P＜0．05）；而FG、hs‐CRP比较，UA组与SAP组间差异无统计学意义（P＞0．05）。SAP组GGT总活性、Hcy、FG、hs‐CRP明显高于对照组（P＜0．05）。跟踪随访1年，高水平GGT（＞60．56 U／L）的患者再次运行心脏事件发生率较高。结论联合检测GGT总活性、Hcy、FG、hs‐CRP可更好地了解冠心病病变程度，尤其是血清GGT总活性和Hcy。GGT总活性与冠心病病变程度密切相关，随访显示GG T总活性高的患者再次运行心脏事件发生率较高。%Objective To retrospectively analyze the relationship between the severity of coronary heart disease and serum total GGT activity .Methods The subjects were divided into unstable angina pectoris group (UA ,n=465) ,stable angina pectoris group (SAP ,n=665)and the control group (angiography negative ,n=126) .The level of serum total GGT activity was measured by enzy‐mic method ,the level of serum homocysteine (Hcy) was measured by circulating enzymic method ,the level of serum hs‐CRP was detected by immunoturbidimetry and the levels of fibrinogen (FG) were also detected .The differences between the three groups were compared .All patients were followed up for one year ,subsequent cardiovascular events (including myocardial infarction , death) were recorded ,and the relationship between the total GGT activity and cardiac events was analyzed .Results The levels of total GGT activity [(43 .74 ± 18 .78)U/L] ,Hcy[(23 .74 ± 8 .78)mol/L] in UA group were significantly higher than SAP group [(30 .13 ± 11 .43)U/L ,(15 .13 ± 11 .43)mol/L ,P<0 .05] .There was no significant difference in FG and hs‐CRP between the two groups (P> 0 .05) .The levels of total GGT activity ,Hcy ,FG ,hs‐CRP in SAP group were significantly higher than the control group(P<0 .05) .The rate of subsequent cardiovascular events was higher in the patients with elevated level of total GGT activity (>60 .56 U/L) .Conclusion Combined detection of GGT ,Hcy ,FG ,hs‐CRP can better understand the degree of coronary heart dis‐ease ,especially the total serum GGT activity and Hcy .Total GGT activity is closely related to the degree of coronary heart disease , and the follow‐up shows that the incidence of cardiac events is higher in the patients with high GGT activity .