| 摘要: |
| 目的:测定冠心病（CHD）患者血浆和肽素（copeptin）水平,探讨其对冠脉病变严重程度的诊断价值。方法:选取因疑似CHD住院而进行冠状动脉造影(CAG)检查的180例患者,按CAG结果分为CHD组(n=101)与对照组(n=79)。CHD组根据冠脉病变支数分为单支病变组（n=38）、双支病变组（n=34）、三支病变组（n=29）；根据Gensini积分分为<20分（n=40）、20～40分（n=29）、≥40分（n=32）组。所有患者造影前均测定收缩压（SBP）、舒张压（DBP）等一般临床特征及生化指标；采用和肽素酶联试剂盒测定血浆copeptin水平,比较不同组别患者copeptin水平,探讨其诊断意义。结果:冠心病患者血浆copeptin水平（ng/ml）显著高于对照组(0.953 6±0.098 6 vs 0.924 4±0.064 9,P＜0.05)。冠状动脉双支病变、三支病变组血浆copeptin水平显著高于对照组和单支病变组(P＜0.05),但前两者间无统计学差异；Gensini积分20～40分、≥40分组患者血浆copeptin水平显著高于对照组和＜20分组(P＜0.05),但前两者间无统计学差异。结论:冠心病患者血浆copeptin水平较高,其在一定程度内可以反映冠脉病变程度,但对于严重冠脉病变可能鉴别意义不大。 |
| 关键词: 和肽素 冠心病 血管造影术 Gensini积分 |
| DOI：10.3724/SP.J.1008.2009.01154 |
| 投稿时间：2009-03-30修订日期：2009-07-27 |
| 基金项目: |
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| Determination of plasma copeptin level in patients with coronary heart disease and its diagnostic value for severity of coronary atherosclerosis |
| YE Zhong1,2,ZHENG Xing1* |
| (1.Department of Cardiology,Changhai Hospital,Second Military Medical University,Shanghai 200433,China; 2.Department of Cardiology,No.313 Hospital of PLA,Huludao 125000) |
| Abstract: |
| Objective:To determine the plasma level of copeptin in patients with coronary heart disease,and to discuss its diagnostic value for severity of coronary atherosclerosis.Methods: Coronary angiography (CAG) was performed in 180 hospitalized patients with suspected coronary heart disease (CHD).The 180 patients were divided into two groups: CHD group (n=101) and non-CHD group (control,n=79) based on the results of CAG.The CHD group was further divided into subgroups according to the number of diseased coronary branches and Gensini’s score: one-vessel subgroup (38),two-vessel subgroup (34) and three-vessel subgroup (29),0＜Gensini’s score＜20 subgroup (40),20≤Gensini’s score＜40 subgroup (29) and Gensini’s score≥40 subgroup (32).Plasma copeptin,lipids,fasting plasma glucose,blood pressure,and body mass index were measured before CAG in all patients; age,sex, and prior medical histories including hypertension,diabetes mellitus, and smoking status were also obtained.Plasma copeptin was determined by radioimmunoassay (RIA) and were compared between different groups.Results: Plasma copeptin level(ng/ml) in CHD patients was significantly higher than that in the controls (0.953 6±0.098 6 vs 0.924 4±0.064 9,P<0.05).Plasma copeptin levels in two-vessel subgroup and three-vessel subgroup were significantly higher than those in the control and one-vessel subgroup (P＜0.05),with no significant difference found between the former two groups.Plasma copeptin levels in 20≤Gensini’s score＜40 subgroup and Gensini’s score≥40 subgroup were significantly higher than those in the control group and 0＜Gensini’s score＜20 subgroup (P＜0.05),with no significant difference found between 20≤Gensini’s score＜40 subgroup and Gensini’s score≥40 subgroup.Conclusion: Plasma copeptin in CHD patients is at a higher level,and to some extent it can reflect the severity of coronary atherosclerosis,but has little value in identification of severe coronary heart diseases. |
| Key words: copeptin coronary heart disease angiography Gensini’s score |
