2021 年第 1 期 第 16 卷

冠心病患者血清胱抑素C及高敏C反应蛋白水平与冠状动脉狭窄程度的相关性研究

Study on the relationship between the levels of serum cystatin C and high sensitive C-reactive protein and the degree of coronary artery stenosis in patients with coronary atherosclerotic heart disease

作者：李俊1秦海霞2孟令东1

英文作者：Li Jun1 Qin Haixia2 Meng Lingdong1

单位：1青海红十字医院心内科，西宁810000；2青海红十字医院急诊重症医学科，西宁810000

英文单位：1Department of Cardiology Qinghai Red Cross Hospital Xining 810000 China; 2Emergency Intensive Care Unit Qinghai Red Cross Hospital Xining 810000 China

关键词：冠心病（冠状动脉粥样硬化性心脏病）；胱抑素C；高敏C反应蛋白；冠状动脉狭窄程度

英文关键词：Coronaryatheroscleroticheartdisease；CystatinC；HighsensitiveC-reactiveprotein；Degreeofcoronaryarterystenosis

• 摘要：

• 目的 探讨冠心病（冠状动脉粥样硬化性心脏病）患者血清胱抑素C及高敏C反应蛋白（hs-CRP）与冠状动脉狭窄程度的相关性。方法选择2016年1月至2018年12月于青海红十字医院拟诊为冠心病并行冠状动脉造影检查的510例患者，根据冠状动脉造影结果，385例患者冠状动脉狭窄（冠心病组），125例患者冠状动脉正常（对照组）。按病变支数将385例冠状动脉狭窄患者分为单支病变组（129例）、双支病变组（148例）和多支病变组（108例）。根据Gensini积分将385例冠状动脉狭窄患者分为高分组（≥82分，75例）、中分组（32～81分，154例）和低分组（≤31分，156例）。比较冠心病组和对照组基线资料，分析胱抑素C及hs-CRP水平与冠状动脉病变狭窄支数、Gensini积分的相关性。结果 冠心病组血清胱抑素C、hs-CRP水平均高于对照组［（0.80±0.17）mg/L比（0.72±0.14）mg/L、2.12（0.92,6.02）mg/L比1.18（0.64,3.42）mg/L］，差异均有统计学意义（均P＜0.05）。单支、双支、多支病变组患者胱抑素C和hs-CRP水平［（0.77±0.15）、（0.81±0.18）、（0.83±0.17）mg/L；1.48(0.73,5.31)、1.99(0.92,4.61)、3.01(1.14,8.74)mg/L］比较，差异均有统计学意义（F=10.041,P<0.001;H=23.008,P<0.001）。胱抑素C、hs-CRP与冠状动脉病变支数均呈正相关（Kendall′s tau-b=0.099、0.131，P=0.013、0.001）。 Gensini积分低分组、中分组、高分组患者胱抑素C和hs-CRP水平［（0.78±0.16）、（0.80±0.17）、（0.84±0.19）mg/L；1.70(0.75,4.27)、2.40(0.93,4.73)、3.36(1.13,15.96)mg/L］比较，差异均有统计学意义（F=3.896,P=0.021;H=13.063,P=0.001）。胱抑素C、hs-CRP与冠状动脉Gensini积分均呈正相关（r=0.203、0.200,均P＜0.001）。结论 冠心病患者血清胱抑素C、hs-CRP与冠状动脉狭窄支数及Gensini积分均呈正相关。

• Objective To discuss the relationship between serum cystatin C, high sensitive C-reactive protein (hs-CRP) and the degree of coronary artery stenosis in patients with coronary atherosclerotic heart disease(CHD). Methods From January 2016 to December 2018, 510 patients with CHD and underwent coronary angiography in Qinghai Red Cross Hospital were selected. According to the results of coronary angiography, the 385 patients with coronary artery stenosis were selected as CHD group, and 125 patients with normal coronary artery were selected as control group. The CHD group were divided into single vessel group (129 cases), double vessels disease group (148 cases) and multiple vessels disease group (108 cases). According to Gensini score, 385 patients with coronary artery stenosis were divided into high group (≥82 scores, 75 cases), medium group (32-81 scores, 154 cases) and low group (≤31 scores, 156 cases). The baseline data of CHD group and control group were compared, and the correlation between cystatin C, hs-CRP levels and coronary artery stenosis number as well as Gensini score were analyzed. Results The levels of serum cystatin C and hs-CRP in CHD group were higher than those in control group［（0.80±0.17）mg/L vs （0.72±0.14）mg/L, 2.12（0.92,6.02）mg/L vs 1.18（0.64,3.42）mg/L］(both P＜0.05). There were significant differences in cystatin C and hs-CRP levels in patients with single vessel, double vessels and multiple vessels lesions［（0.77±0.15）, （0.81±0.18）, （0.83±0.17）mg/L； 1.48(0.73,5.31), 1.99(0.92,4.61), 3.01(1.14,8.74)mg/L］ (all P＜0.05). Cystatin C and hs-CRP were positively correlated with the number of coronary artery lesions (Kendall′s tau-b=0.099, 0.131, P=0.013, 0.001). The levels of cystatin C and hs-CRP in patients with low, medium and high Gensini scores were significantly different［（0.78±0.16）, （0.80±0.17）, （0.84±0.19）mg/L；1.70(0.75,4.27), 2.40(0.93,4.73), 3.36(1.13,15.96)mg/L］(all P＜0.05). Cystatin C and hs-CRP were positively correlated with Gensini score (r=0.203, 0.200, all P＜0.001). Conclusions  erum cystatin C and hs-CRP are positively correlated with the number of coronary artery lesions and Gensini score in patients with CHD.