标题：冠心病患者血清脂蛋白、血尿酸水平与冠脉狭窄程度的相关性

      作者：周春娟 1，毛文娟 1，王瑜硕 1，马成龙 2    1.宝鸡市金台医院心内科，陕西 宝鸡 721001；2.汉中市人民医院重症医学科，陕西 汉中 723000

      卷次： 2019年30卷24期

      【摘要】 目的 分析冠心病患者血清脂蛋白、血尿酸水平与冠脉狭窄程度的相关性。方法 选取 2018年 3月至 2019年 3月期间宝鸡市金台医院心内科收治的 98例冠心病患者为研究对象，将其中 32例单支病变的冠心病患者作为A组，30例 2支冠状动脉病变的冠心病患者作为B组，36例多支冠状动脉病变的冠心病患者作为C组，选取同期 50例健康体检者作为对照组。所有患者和健康体检者均经冠脉造影检查并计算Gensini评分。比较各组受检者在血清脂蛋白(α) [Lp(α)]、纤维蛋白原(FIB)、总胆红素(TBIL)、血尿酸(UA)方面的差异，并采用Spearman相关分析法观察上述指标与冠脉狭窄的相关性。结果 A组、B组、C组患者的Lp(α)分别为(213.01±77.13) mg/dL、(317.38±102.14) mg/dL和 (346.28±112.30) mg/dL，FIB分别为 (3.65±0.85) g/L、(3.97±1.14) g/L和(4.23±0.75) g/L，UA分别(305.02±70.68) μmol/L、(329.35±66.52) μmol/L和(377.31±98.87) μmol/L，明显高于对照组的 (182.57±54.52) mg/dL、(3.45±0.64) g/L和 (287.33±92.24) μmol/L，而 TBIL分别为 (13.82±2.73) μmol/L、(11.69±0.81) μmol/L和(9.88±1.01) μmol/L，明显低于对照组的(15.25±3.88) μmol/L，差异均具有统计学意义(P<0.05)；A组、B组和C组患者的Gensini评分分别为(30.13±17.82)分、(55.81±20.18)分和(72.27±25.53)分，明显高于对照组的(14.45±2.95)分，差异均具有统计学意义(P<0.05)；Lp(α)、FIB及UA与冠脉狭窄程度均呈明显正相关(r=0.854、0.651、0.682，P<0.05)，而TBIL则与冠脉狭窄程度呈明显负相关(r=-0.583，P<0.05)。结论 冠心病患者的Lp(α)、FIB、UA含量升高，TBIL含量降低，且与冠脉狭窄程度相关，能够预测并判断冠心病严重程度，在临床中具有一定的应用价值。
      【关键词】 冠心病；血尿酸；血清脂蛋白；冠脉狭窄；纤维蛋白原
      【中图分类号】 R541.4 【文献标识码】 A 【文章编号】 1003—6350（2019）24—3152—04

Relationship between the level of serum lipoprotein, serum uric acid and degree of coronary stenosis in patientswith coronary heart disease.
ZHOU Chun-juan 1, MAO Wen-juan 1, WANG Yu-shuo 1, MA Cheng-long 2. 1. Department ofCardiology, Jintai Hospital, Baoji 721001, Shaanxi, CHINA; 2. Department of Critical Care Medicine, Hanzhong People'sHospital, Hanzhong 723000, Shaanxi, CHINA
【Abstract】 Objective To analyze the correlation between the level of serum lipoprotein and uric acid and thedegree of coronary stenosis. Methods A total of 98 patients with coronary heart disease, who admitted to Department ofCardiology, Jintai Hospital from March 2018 to March 2019, were selected as the study objects. Among them, 32 patientswith single coronary artery disease were selected as group A, 30 patients with two coronary artery disease as group B, 36patients with multiple coronary artery disease as group C, and 50 healthy people were enrolled into the control group. Allpatients were examined by coronary angiography and the Gensini score was calculated. The differences of lipoprotein (α)(Lp(α)), fibrinogen (FIB), total bilirubin (TBIL) and uric acid (UA) among the four groups were compared, and the correla-tion between the above indexes and coronary stenosis was observed by Spearman correlation analysis. Results The lev-els of Lp(α) in the group A, B and C were (213.01±77.13) mg/dL, (317.38±102.14) mg/dL, and (346.28±112.30) mg/dL,respectively, the levels of FIB in the group A, B and C were (3.65±0.85) g/L, (3.97±1.14) g/L, and (4.23±0.75) g/L, respec-tively, and the levels of UA in the group A, B and C were (305.02±70.68) μmol/L, (329.35±66.52) μmol/L, and (377.31±98.87) μmol/L, which were significantly higher than corresponding (182.57±54.52) mg/dL, (3.45±0.64) g/L and (287.33±92.24) μmol/L in the control group (all P<0.05); the levels of TBIL in the group A, B and C were (13.82±2.73) μmol/L,(11.69±0.81) μmol/L and (9.88±1.01) μmol/L, which were significantly lower than (15.25±3.88) μmol/L in the controlgroup (P<0.05); the Gensini scores of group A, B and C were 30.13±17.82, 55.81±20.18 and 72.27±25.53, respectively,which were significantly higher than 14.45±2.95 in the control group (P<0.05); Lp(α), FIB and UA were positively corre-lated with the severity of coronary stenosis (r=0.854, 0.651, 0.682, P<0.05), while TBIL was negatively correlated withthe severity of coronary stenosis (r=-0.583, P<0.05). Conclusion The increase of Lp(α), FIB and UA as well as the de-crease of TBIL are closely related to the degree of coronary stenosis, and it can be used to predict and judge the severityof coronary heart disease, and has certain value in clinical practices.
      【Key words】 Coronary heart disease; Serum uric acid; Serum lipoprotein; Coronary artery stenosis; Fibrinogen