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目的①观察冠心病患者血清可溶性P-选择素、高敏C-反应蛋白及同型半胱氨酸水平,研究三者能否预测冠心病的严重程度。②通过实验研究冠心病患者可溶性P-选择素、高敏C-反应蛋白和同型半胱氨酸水平三者的相关性,探讨血小板功能与内皮细胞功能及血管炎症反应间的关系。方法本研究选取急性心肌梗死患者(AMI组)21例,不稳定型心绞痛患者(UAP组)25例,稳定型心绞痛患者(SAP组)20例和冠脉造影排除冠心病者(对照组)20例。用ELISA法测定其血清可溶性P-选择素、hs-CRP和同型半胱氨酸水平。结果①P-选择素、hs-CRP、Hcy水平分别在AMI组、UAP组和SAP组,两两比较差异有统计学意义(P均<0.05),而SAP组和对照组比较差异无统计学意义(P>0.05)。②冠心病患者P-选择素与hs-CRP相关系数r=0.456(P<0.05),Hcy与hs-CRP相关系数r=0.210(P<0.05),P-选择素与Hcy相关系数r=0.848(P<0.05)。结论①P-选择素、hs-CRP和Hcy水平在AMI组和UAP组较SAP组和对照组明显升高,其中AMI组最高,其次为UAP组,再次为SAP组。②血清Hcy水平,Hs-CRP水平及P-选择素水平具有良好的正相关性,均随病情的严重程度的加重而升高。联合检测三者可协助了解病情,为指导治疗及判断预后提供依据。
Objectives ① To observe the serum levels of soluble P-selectin, high-sensitivity C-reactive protein and homocysteine in patients with coronary heart disease (CHD), and to study whether the three can predict the severity of coronary heart disease. (2) The relationship between platelet function, endothelial cell function and vascular inflammation was investigated through the correlation between soluble P-selectin, high-sensitivity C-reactive protein and homocysteine in patients with coronary heart disease. Methods In this study, 21 patients with acute myocardial infarction (AMI group), 25 patients with unstable angina pectoris (UAP group), 20 patients with stable angina pectoris (SAP group) and 20 patients with coronary artery disease (control group) with coronary angiography example. Serum soluble P-selectin, hs-CRP and homocysteine levels were measured by ELISA. Results ① The levels of P-selectin, hs-CRP and Hcy in the AMI group, the UAP group and the SAP group were significantly different (all P <0.05), but there was no significant difference between the SAP group and the control group (P> 0.05). The correlation coefficient between P-selectin and hs-CRP was 0.456 (P <0.05), the correlation coefficient between Hcy and hs-CRP was 0.210 (P <0.05), the correlation coefficient between P-selectin and Hcy was 0.848 (P <0.05). Conclusion ① The levels of P-selectin, hs-CRP and Hcy in AMI group and UAP group were significantly higher than those in SAP group and control group, the highest in AMI group, followed by UAP group and again in SAP group. ② Serum Hcy level, Hs-CRP level and P-selectin level had a good positive correlation with the severity of the disease increased. Joint detection of the three can help understand the condition, to provide guidance for the treatment and prognosis.