目的:探讨冠心病(CHD)患者炎性因子、尿酸(UA)、同型半胱氨酸(Hcy)及小而密低密度脂蛋白(sdLDL-C)水平变化及意义。方法:选取152例CHD患者作为CHD组,包括稳定型心绞痛(SAP组,n=48)、不稳定型心绞痛(UAP组,n=55)和急性心肌梗死(AMI组,n=49),依据Gensinis评分又可分为轻度组(n=88),中度组(n=43)及重度组(n=21),同期另选取健康体检者55例作为对照组。比较不同类型CHD患者及不同冠状动脉病变程度间患者及对照组血清炎性因子[超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)]、UA、Hcy及sdLDL-C水平。结果:CHD组hs-CRP、TNF-α、UA、Hcy及sdLDL-C水平均显著高于对照组,差异有统计学意义(P<0.05)；CHD组中,UAP组与AMI组hs-CRP、TNF-α、UA、Hcy及sdLDL-C水平均显著高于SAP组,且AMI组水平显著高于UAP组,差异有统计学意义(P<0.05)；与轻度组hs-CRP、TNF-α、UA、Hcy及sdLDL-C水平比较,中度组及重度组水平均显著升高,且重度组水平显著高于中度组,差异比较均有显著性(P<0.05)。结论:冠心病者血清炎性因子、UA、Hcy及sdLDL-C水平均显著升高,其水平检测对冠心病诊断及病情严重程度评估具有重要意义。

Objective: To investigate the changes and significance of serum inflammatory factors, uric acid (UA), homocysteine (Hcy) and small dense low-density lipoprotein (sdLDL-C) levels in patients with coronary heart disease (CHD). Methods: 152 patients with CHD were selected as the CHD group, including stable angina pectoris (SAP group, n=48), unstable angina pectoris (UAP group, n=55), and acute myocardial infarction (AMI group, n=49), according to the Gensinis score, it can be divided into mild group (n=88), moderate group (n=43) and severe group (n=21), at the same time 55 healthy people were selected as control group. The serum inflammatory factors [hypersensitivity C reactive protein (hs-CRP), tumor necrosis factor -α (TNF-α)], UA, Hcy and sdLDL-C levels were compared between patients with different CHD and different degree of coronary artery lesions. Results: The levels of hs-CRP, TNF-α, UA, Hcy and sdLDL-C in the CHD group were significantly higher than those in the control group (P<0.05); In the CHD group, the levels of hs-CRP, TNF-α, UA, Hcy and sdLDL-C in the UAP group and AMI group were significantly higher than those off the SAP group, and the level of AMI group [(7.96±1.49) mg/L, (92.87±14.50) ng/L, (417.75±43.88) mol/L, (23.25±7.33) and mol/L (1.31± 0.53) mmol/L] was significantly higher than that of UAP group [(6.15±0.97) mg/L, (73.88 ±9.27) ng/L, (393.63±68.29) mol/L, (19.67±7.26) mol/L and (1.08±0.44) mmol/L] (P<0.05); Compared with mild group hs-CRP, TNF-α, UA, Hcy and sdLDL-C levels, the levels of the moderate group and severe group were significantly increased, and the level of severe group was significantly higher than that of moderate group (P<0.05). Conclusion: The levels of serum inflammatory factors, UA, Hcy and sdLDL-C in patients with coronary heart disease are significantly increased, and the detection of the levels has a great significance for the diagnosis of coronary heart disease and the assessment of the severity of coronary heart disease.

R541.4

湖北省科技计划项目； (编号:2015SK1227)；