Abstract:Objective To explore the connection between levels of serum homocysteine (Hcy), high sensitivity C-reative protein (hs-CRP) and cystatin C (Cys C) and coronary atherosclerotic. Methods A total of 245 patients accepting Multi-Slics spiral CT coronary angiography (MSCTCA) in Department of Cardiology, the Second Affiliated Hospital of Nanjing Medical University from August 2016 to January 2018 were selected. According to whether coronary stenosis≥50% or not, all the cases were divided into non coronary stenosis group (90 cases) and coronary stenosis group (155 cases)(116 patients with hypertention). According to number of affected vessel with coronary stenosis≥50%, all the cases were divided into single vessel affected group (48 cases), double vessels affected group (45 cases), multiple vessels affected group (62 cases). According to degree of coronary artery stenosis, the patients were divided into four groups: degreeⅠ group: reduced lumen area 1%-25% (30 cases); degree Ⅱ group: reduced lumen area <25%-50% (60 cases); degree Ⅲ group: reduced lumen area <50%-75% (120 cases); degree Ⅳ group: reduced lumen area <75%-100% (35 cases). Hcy, hs-CRP and Cys C were compared among the coronary atherosclerotic with different types. Results Compared with the non coronary stenosis group, Hcy, hs-CRP and Cys C coronary in the stenosis group were higher (P < 0.05). Compared with coronary stenosis group, Hcy, hs-CRP and Cys C of patients with hypertension of coronary stenosis group were higher (P < 0.05). Compared with the non coronary stenosis group, Hcy, hs-CRP, Cys C were higher in the other groups (P < 0.05). Compared with the single vessel affected group, Hcy, hs-CRP in double vessels affected group and multiple vessels affected group were higher (P < 0.05). Compared with the dagree Ⅰgroup, Hcy, hs-CRP, Cys C were higher in the degreeⅡ-Ⅲ groups, Hcy, hs-CRP in the degree Ⅳ group were higher (P < 0.05). Compared with the dagree Ⅱ group, Hcy, hs-CRP, Cys C in the degree Ⅲ group were higher, Hcy, hs-CRP in the degree Ⅳ group were higher (P < 0.05). Compared with the dagree Ⅲ group, Hcy, hs-CRP in the degree Ⅳ group were higher (P < 0.05). Conclusion High levels of serum Hcy, hs-CRP and Cys C have relationship with coronary atherosclerosis. Combined with normal test, regularly testing the levels of serum Hcy, hs-CRP and Cys C is helpful for the evaluation of coronary artery affected vessel number and stenosis degree, which can guide clinical treatment and improve coronary atherosclerosis patients′ treatment efficacy and prognosis.
蒯琳 洪梅▲. 血清同型半胱氨酸、高敏C反应蛋白、胱抑素C水平与冠状动脉粥样硬化的关系[J]. 中国医药导报, 2018, 15(35): 58-61.
KUAI Lin HONG Mei▲. Connection of homocysteine, hig sensitivity C-reative protein and cystatin C with coronary atherosclerosis. 中国医药导报, 2018, 15(35): 58-61.
[1] 吴震,宋伟,方颖.多层螺旋CT冠脉成像评估冠脉狭窄病变的临床价值[J].中国CT和MR杂志,2016,14(6):25-27.
[2] Strakova J,Gupta S,Kruger WD,et al. Inhibition of betainehomo cysteine S-methyltransferase in rats causes hyperhomocysteinemia and reduces liver cystathionine B-synthase activity and methylation capacity [J]. Nutr Res,2011,31(7):563-571.
[3] Cho DY,Kim KN,Kim KM,et al. Combination of high-sensitivity C-reactive protein and homocysteine may predict an increased risk of coronary artery disease in Korean population [J]. Chin Med J:En91,2012,125(4):569-573.
[4] 贺涛,唐芝加,李刚,等.胱抑素C水平与冠心病的相关性研究[J].中华老年心脑血管病杂志,2012,107(1):149-158.
[5] 马礼坤.美国心脏病学院和美国心脏学会新的不稳定性心绞痛/非ST段抬高性心肌梗死的诊断和治疗指南解读[J].临床内科杂志,2007(12):808-810.
[6] 蒋承建,郭航飞,赵飞.依那普利叶酸对H型高血压治疗研究进展[J].心脑血管病防治,2014,14(4):322-324.
[7] Jatoez A,Nowicka G. C-reactive protein and homocysteineas risk factors of atherosclerosis [J]. Przegl Lek,2008, 65(6):268-272.
[8] Esteghamati A,Hafezi-Nejad N,Zandieh A,et al. Homocysteine and metabolic syndrome:From clustering to additional utility in prediction of coronary heart disease [J]. J Cardiol,2014,64(4):290-296.
[9] 荣嵘,张爱民,樊春红,等.血清同型半胱氨酸与冠心病患者及多项生化指标关系的分析[J].中国实验诊断学,2009,13(1):77-80.
[10] 鄢高亮,王栋,乔勇,等.高同型半胱氨酸水平对冠心病严重程度及支架置入治疗后的影响[J].中华心血管病杂志,2015,43(11):943-949.
[11] Rider PM. High sensitivity C-reactive potential potential adjunct for global risk assessment in the primary prevention at cardiovascular disease [J]. Circulation,2001,103(13):1818.
[12] 许贵华,朱豫.C反应蛋白对判断冠心病预后价值的研究现状[J].心血管病学进展,2014,35(4):503-505.
[13] 梁潇潇,刘学文.急性脑梗死与Cys C及hs-CRP相关性的研究[J].中国神经精神疾病杂志,2015,41(3):168-171.
[14] Heart Protection Study Collaborative Group, Jonathan Emberson,Derrick Bennett,et al. C-reative protein concentration and the vascular benefits of statin therapy:an analysis of 20,536 patients in the heart protection study [J]. Lancet,2011,377(9764):469-476.
[15] Choe JY,Papk SH,Kim SK. Serum cystatin C is a potential endogenous marker for the estimation of renal function in male gout patients with renal impairment [J]. J Korean Med Sci,2010,25(1):42-48.
[16] Salgado JV,Souza FL,Salgado BJ. How to understand the association between cystatin C levels and cardiovascular disease:imbalance,counterbalance,or consequence? [J]. J Cardiol,2013,62(6):331-335.
[17] 徐志强.胱抑素C与冠心病相关性的研究进展[J].心血管病学进展,2008,29(1):64-67.
[18] Koenig W,Twardella D,Brenner H,et al. Plasma concentrations of cystatin C in patients with coronary heart disease and risk for secondary cardiovascular events:more than simply a marker of glomerular filtration rate [J]. Clin Chern,2005,51:321-327.
[19] 李俊,李彬,齐娟飞,等.联用叶酸、维生素B6和维生素B12降低同型半胱水平影响心血管疾病风险的荟萃分析[J].中华心血管病杂志,2015,43(6):554-556.
[20] 姚立岩,杨晓炜,李海红,等.C反应蛋白与缺血性脑卒中关系的研究进展[J].中国老年学杂志,2016,36(17):4370-4373.
[21] 夏明栓.阿司匹林联合阿托伐他汀钙对急性脑梗死患者C反应蛋白的影响[J].中西医结合心脑血管病杂志,2015,13(4):549-550.