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目的:测定冠心病(CHD)患者血浆和肽素(copeptin)水平,探讨其对冠脉病变严重程度的诊断价值。方法:选取因疑似CHD住院而进行冠状动脉造影(CAG)检查的180例患者,按CAG结果分为CHD组(n=101)与对照组(n=79)。CHD组根据冠脉病变支数分为单支病变组(n=38)、双支病变组(n=34)、三支病变组(n=29);根据Gensini积分分为<20分(n=40)、20～40分(n=29)、≥40分(n=32)组。所有患者造影前均测定收缩压(SBP)、舒张压(DBP)等一般临床特征及生化指标;采用和肽素酶联试剂盒测定血浆copeptin水平,比较不同组别患者copeptin水平,探讨其诊断意义。结果:冠心病患者血浆copeptin水平(ng/ml)显著高于对照组(0.9536±0.0986vs0.9244±0.0649,P<0.05)。冠状动脉双支病变、三支病变组血浆copeptin水平显著高于对照组和单支病变组(P<0.05),但前两者间无统计学差异;Gensini积分20～40分、≥40分组患者血浆copeptin水平显著高于对照组和<20分组(P<0.05),但前两者间无统计学差异。结论:冠心病患者血浆copeptin水平较高,其在一定程度内可以反映冠脉病变程度,但对于严重冠脉病变可能鉴别意义不大。
OBJECTIVE: To determine the plasma levels of copeptin in patients with coronary heart disease (CHD) and investigate its diagnostic value for the severity of coronary lesions. METHODS: 180 patients undergoing coronary angiography (CAG) for suspected CHD hospitalization were divided into CHD group (n = 101) and control group (n = 79) according to CAG results. Patients in the CHD group were divided into two groups according to the number of coronary lesions (n = 38), the double-vessel lesion group (n = 34) and the three-vessel lesion group (n = 29) = 40), 20-40 points (n = 29), ≥40 points (n = 32) group. All patients were measured before systolic blood pressure (SBP), diastolic blood pressure (DBP) and other general clinical features and biochemical indicators; copeptin kit using plasma copeptin levels were compared copeptin levels in different groups were compared to explore the diagnostic significance . Results: The plasma levels of copeptin (ng / ml) in patients with coronary heart disease were significantly higher than those in the control group (0.9536 ± 0.0986 vs 0.9244 ± 0.0649, P <0.05). There was no significant difference between the two groups in coronary artery disease and in the three lesions (P <0.05), but there was no significant difference between the two groups (P> 0.05). The patients with Gensini score of 20-40, Plasma copeptin levels were significantly higher than those in the control group and <20 group (P <0.05), but there was no significant difference between the two groups. Conclusion: Plasma copeptin level is high in patients with coronary heart disease, which can reflect the degree of coronary artery lesion to a certain extent, but may not be meaningful for the diagnosis of severe coronary artery lesion.