血清D-D、hsCRP及LP （a）含量检测诊断冠心病的价值

目的：探讨血清D-二聚体（D-D）、超敏C反应蛋白（hsCRP）及脂蛋白（a）LP（a）]含量检测诊断冠心病（CHD）的价值.方法：选择128例CHD患者（CHD组）及40例健康体检者（健康对照组）,CHD组又分为急性心肌梗死（AMI）组、不稳定型心绞痛（UAP）组和稳定型心绞痛（SAP）组,检测各组血清D-D、hsCRP及LP（a）水平,比较三项指标单独检测和联合检测诊断CHD的阳性率.结果：与健康对照组比较,CHD组血清hsCRP（2.9±1.8） mg/L比（12.8±6.7） mg/L]、LP（a）（203.6±95.4） mg/L比（398.7±146.8） mg/L]、D-D（151.2±59.4） ng/L比（267.3±144.8） ng/L]水平均显著升高（P均＜0.01）,且AMI组显著高于UAP、SAP组,UAP患者显著高于SAP患者（P均＜0.01）;hsCRP、LP（a）、D-D联合检测诊断CHD的敏感性（95.3％）均显著优于各项单独检测（85.9％、82.8％、74.2％）,P＜0.05或＜0.01.结论：血清超敏C反应蛋白、脂蛋白（a）及D-二聚体的含量反映了患者病情程度,且三项联合检测更能提高CHD的诊断敏感性,具有重要价值.

Diagnostic value detecting serum D-D,hsCRP and LP (a) for coronary heart disease

Objective： To explore diagnostic value detecting serum D-dimer （D-D）, high sensitive C reactive protein （hsCRP） and lipoprotein a Lp （a）] for coronary heart disease （CHD）. Methods： A total of 128 CHD patients （CHD group） and 40 healthy subiects （healthy control group） were enrolled. CHD group was further divided into a- cute myocardial infarction （AMI） group, unstable angina pectoris （UAP） group and stable angina pectoris （SAP） group. Serum levels of D-D, hsCRP and LP （a） were measured in all groups. Diagnosing sensitivity for CHD by sin- gle and combined detection of these three indexes was compared. Results： Compared with health control group, there were significant rise in serum levels of hsCRP （2.9 ± 1.8） mg/L vs. （12.8 ± 6.7） mg/L], LP （a） （203.6 ± 95.4） mg/L vs. （398.7 ± 146.8） mg/L] and D-D （151.2 ± 59.4） ng/L vs. （267.3 ± 144.8） ng/L] in CHD group （P〈0.01 all）, and those of AMI group were significantly higher than those of UAP group and SAP group, and those of UAP group were significantly higher than those of SAP group （P〈0.01 all）; combined detection of hsCRP, Lp （a） and D-D possessed significant higher sensitivity （95.3%） diagnosing CHD than single detection of these three indexes （85.9%, 82.8%, 74.2%）, P,〈0.05 or 〈0.01. Cnnelusion~ Serum concentrations of high sen- sitive C reactive protein, lipoprotein （a） and D-dimer reflect patient＇s condition degree, and combined detection of three indexes can significantly elevate diagnostic sensitivity of CHD, so possesses important value.