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目的评估SA、Hcy、IL-6联合检测在冠心病(CHD)危险分层中的临床意义及预后判定中的临床价值。方法收集接受冠状动脉造影患者305例,其中急性心肌梗塞患者82例(AMI组),不稳定型心绞痛患者139例(UA组),稳定型心绞痛84例(SA组),另收集100例冠状动脉造影正常患者为对照组,分别检测SA、Hcy、IL-6水平。结果 CHD各亚组患者的SA、Hcy及IL-6水平随着CHD的临床危险增加而升高,差异有统计学意义(P<0.05)。其中对照组与CHD组的SA、Hcy及IL-6的血清浓度水平明显不同,差异有统计学意义(P<0.05)。PCI术后血浆SA、Hcy和IL-6水平较术前明显降低,差异有统计学意义(P<0.05)。单因素方差分析表明,SA、Hcy及IL-6的血清浓度水平与冠状动脉狭窄的支数无关。SA组、UA组以及AMI组的SA+Hcy+IL-6联合检测的阳性率均高于单项指标检测的阳性率。结论单项指标检测对CHD的预测、诊断价值有限,3项指标联合检测能够提高CHD诊断水平并有效预测CHD病情发展程度,为临床冠心病危险分级提供依据。
Objective To evaluate the clinical significance and the clinical value of combined detection of SA, Hcy and IL-6 in the risk stratification of coronary heart disease (CHD). Methods A total of 305 patients undergoing coronary angiography were enrolled. Among them, 82 patients (AMI group), 139 patients with unstable angina pectoris (UA group), 84 patients with stable angina (SA group) and 100 patients with coronary artery Patients with normal contrast as control group were detected SA, Hcy, IL-6 levels. Results The levels of SA, Hcy and IL-6 in CHD subgroups increased with the clinical risk of CHD, the difference was statistically significant (P <0.05). Serum concentration of SA, Hcy and IL-6 in control group and CHD group were significantly different (P <0.05). The levels of SA, Hcy and IL-6 in plasma after PCI were significantly lower than those before operation (P <0.05). One-way ANOVA showed that serum concentrations of SA, Hcy and IL-6 were not related to the number of coronary stenosis. The positive rates of SA + Hcy + IL-6 in SA group, UA group and AMI group were higher than those in single index test. Conclusions The detection of CHD by single index is limited and the diagnostic value is limited. Combined detection of three indexes can improve the diagnosis of CHD and predict the progression of CHD effectively, so as to provide the basis for clinical CHD risk classification.