摘要
目的分析血脂结合胱抑素C(cystatin C,CysC)、同型半胱氨酸(homocysteine,Hcy)检测对冠心病的诊断价值。方法纳入冠心病疑似患者96例,诊治时间为2020年2月至2021年2月,所有患者均行血脂(总胆固醇、低密度脂蛋白胆固醇和高密度脂蛋白胆固醇)、CysC、Hcy检测,根据受试者工作特征(receiver operating characteristic,ROC)曲线分析疾病诊断价值;以冠状动脉造影检查为金标准,根据纽约心脏协会(New York Heart Association,NYHA)心功能分级和冠状动脉狭窄程度对确诊患者分组处理,对比不同心功能和不同狭窄程度患者血脂、CysC、Hcy水平。结果血脂指标疾病检出率为80.88%,CysC为79.41%,Hcy为83.82%,均低于3项检测联合,差异有统计学意义(P<0.05);ROC曲线显示指标联合检测AUC(95%CI)为0.997(0.956~1.000),截断值为12.19,灵敏度和特异性分别为100.00%和95.59%;患者心功能分级越高,血脂(除高密度脂蛋白胆固醇外)越高,CysC和Hcy分别为1.56±0.18mg/L和24.21±4.16μmol/L,与心功能III级和心功能IV级比较,差异有统计学意义(P<0.05);高密度脂蛋白胆固醇除外,不同狭窄程度患者血脂、CysC和Hcy水平与正常无狭窄者比较明显提高,差异有统计学意义(P<0.05)。结论较之于单项生化检测指标,血脂结合CysC、Hcy检测对冠心病进行诊断时,灵敏度和特异性更高,各项指标随着心功能分级和冠状动脉狭窄程度增加出现明显变化趋势,可评估疾病严重程度。
Objective To evaluate the diagnostic value of blood lipid detection combined with cystatin C(CystatinC,CysC)and homocysteine(Hcy)in the diagnosis of coronary heart disease.Methods A total of 96 patients with suspected coronary heart disease were enrolled for the study.The diagnosis and treatment time widow was from February,2020 to February,2021.Receiver Operating Characteristic(Receiver Operating Characteristic)curve was drawn to evaluate the diagnostic value of these markers;Using coronary angiography as the gold standard,all diagnosed patients were grouped according to the New York Heart Association(NYHA)cardiac function classification and coronary stenosis degree,and we compared levels of blood lipids,CysC and Hcy among patients with different cardiac functions and different degrees of stenosis.Results The disease detection rate of blood lipid index was 80.88%,with CysC of 79.41%,and Hcy of 83.82%.All were significantly lower than the combination of the three-marker tests(P<0.05);ROC curve shoed the AUC(95%CI)as 0.997(0.956-1.000),with the cutoff value of 12.19,the sensitivity and specificity of 100.00%and 95.59%,respectively;The higher the cardiac function grade of the patients,the higher the lipid profile(except for HDL cholesterol)was.CysC and Hcy were 1.56±0.18mg/L and 24.21±4.16μmol/L,respectively.When compared with cardiac and cardiac function levels,the difference was statistically significant(P<0.05);The exception of HDL cholesterol,Blood lipid,CysC and Hcy levels in patients with different stenosis levels were significantly increased compared with normal patients without stenosis(P<0.05).Conclusion Compared with a single biochemical detection index,blood lipid detection combined with CysC and Hcy has a higher sensitivity and specificity in diagnosing coronary heart disease.Each index shows a significant change trend with the increase of cardiac function classification and coronary artery stenosis,which can be used to evaluate the disease.severity.
作者
张芳琼
李彩华
韩骏飞
ZHANG Fangqiong;LI Caihua;HAN Junfei(Zigui County People’s Hospital,Zigui 443600,China)
出处
《标记免疫分析与临床》
CAS
2023年第12期2107-2111,共5页
Labeled Immunoassays and Clinical Medicine
关键词
血脂
胱抑素C
同型半胱氨酸
冠心病
心功能分级
冠状动脉狭窄程度
Blood lipids
Cystatin C
Homocysteine
Coronary heart disease
Cardiac function classification
Degree of coronary stenosis
