4项联合检测在冠心病患者中的临床应用价值

目的探讨血尿酸(SUA)、C-反应蛋白(CRP)、纤维蛋白原(FIB)和平均血小板体积(MPV)水平在冠心病(CHD)患者诊断和疗效观察中的临床应用。方法选择达州市中心医院2009年1月至2011年6月CHD患者293例(CHD组)及50例健康体检者(健康对照组),其中CHD组又分成3组:急性心肌梗死(AMI)组115例;不稳定型心绞痛(UAP)组92例;稳定型心绞痛(SAP)组86例。所有患者均在禁食12h后采集静脉血,检测UA、CRP、FIB和MPV。结果 (1)CHD患者与健康对照组血清SUA、CRP、FIB和MPV水平比较,SUA、CRP、FIB和MPV水平显著升高,差异有统计学意义(P<0.01);(2)AMI组、UAP组和SAP组分别与对照组比较,SUA、CRP、FIB和MPV水平差异均有统计学意义(P<0.01);(3)SAP组与UAP组比较,SUA、CRP、FIB和MPV水平差异无统计学意义(P>0.05);(4)AMI组与SAP组和UAP组分别比较,SUA、CRP、FIB和MPV水平差异有统计学意义(P<0.01)。结论综合分析测定UA、CRP、FIB和MPV,对全面了解CHD的进程有重要意义,高UA、高CRP、高FIB和MPV增大可能是CHD患者的危险因子,是动脉粥样硬化斑块不稳定的重要因素;这4种水平的增高更是与AMI的发生和发展密切相关。

Clinical application value of combined detections of serum uric acid,C-reaction protein,fibrinogen and mean platelet volume in patients with coronary heart disease

Objective To explore diagnosis and curative effects of clinical application of serum uric acid（UA）,C-reactive protein（CRP）,fibrinogen（FIB） and mean platelet volume（MPV） levels in coronary heart disease（CHD） patients.Methods From January 2009-June 2011,293 patients with coronary heart disease（CHD group） and the healthy check-up of 50 patients（control group） were chosen from hospital,CHD patients were divided into three groups：115 cases of acute myocardial infarction（AMI） group;92 patients with unstable angina（UAP） group;86 patients with stable angina（SAP） group.All of the patients′ venous blood samples were collected after 12 hours fasting for testing uric acid,C-reaction protein,fibrinogen and mean platelet volume.Results（1）Compare to normal control group,Coronary heart disease patients′ SUA,CRP,FIB and MPV levels were significantly increased,the difference was statistically significant（P0.01）.（2）Compare to normal control group,AMI,UAP and SAP groups′ SUA,CRP,FIB and MPV levels were significantly changed（P0.01）.（3）SUA,CRP,FIB and MPV levels were not significantly different between SAP group and UAP group（P0.05）.（4）Compare to SAP,UAP groups,AMI group′s SUA,CRP,FIB and MPV levels were significantly different（P0.01）.Conclusion Comprehensive analysis of the determination of serum uric acid,C-reactive protein,fibrinogen,and mean platelet volume can have important value of understanding of the process of CHD.High blood uric acid,high C-reactive protein,high fibrinogen,and high MPV may be the risk factors for coronary heart disease,and also be important factors for atherosclerotic plaque instability.These were related acute myocardial infarction and development closely too.