本文關(guān)鍵詞： 視黃醇結(jié)合蛋白4 同型半胱氨酸 超敏C反應(yīng)蛋白 冠心病　出處：《安徽醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：【目的】探討血清視黃醇結(jié)合蛋白4(RBP4)在冠心病患者冠脈病變程度及其預(yù)后中的臨床意義�！痉椒ā繉�(duì)收住我科,擬診冠心病患者行冠狀動(dòng)脈造影術(shù)210例。明確診斷為冠心病者160例,其中急性心肌梗死組69例,不穩(wěn)定型心絞痛組35例,穩(wěn)定型心絞痛組56例,余造影結(jié)果正常者50例作為對(duì)照組。再根據(jù)冠脈造影結(jié)果將冠心病者分為單支病變組40例,雙支病變組63例、多支病變組57例;按照Gensini積分分為輕度病變組36例、中度病變組46例、重度病變組44例、極重度病變組34例。所有入選患者集中檢測(cè)血清RBP4、HCY及Hs-CRP。分析RBP4水平與冠狀動(dòng)脈病變程度的相關(guān)性;對(duì)急性冠脈綜合征患者門診或電話隨訪6個(gè)月,分析比較血清RBP4水平變化與主要不良心血管事件(MACE)發(fā)生率的相關(guān)性�！窘Y(jié)果】1.與對(duì)照組比較AMI組、UAP組、SAP組血清RBP4、HCY、Hs-CRP水平顯著增高(P0.01)。2.AMI組、UAP組血清RBP4、HCY、Hs-CRP水平明顯高于SAP組(P0.05);血清RBP4水平在AMI組和UAP組間差異無統(tǒng)計(jì)學(xué)意義(P0.05)。3.單支病變組、雙支病變組、多支病變組血清RBP4、HCY、Hs-CRP水平明顯高于對(duì)照組(P0.05),隨著冠狀動(dòng)脈病變支數(shù)的增多,血清RBP4、HCY、Hs-CRP水平也明顯增高,各組間差異有統(tǒng)計(jì)學(xué)意義(P0.05)。4.輕度病變組、中度病變組、重度病變組、極重度病變組血清RBP4水平逐漸升高,各組間比較有明顯差異,有統(tǒng)計(jì)學(xué)意義(P0.05)。5.ACS以血清RBP4中位數(shù)值(28mg/L)為依據(jù),血清RBP4≥28mg/L的ACS患者隨訪中MACE的發(fā)生率(46%)明顯高于RBP4水平28mg/L的患者(8%)。6.冠心病患者血清RBP4水平與冠脈Gensini評(píng)分、HCY、Hs-CRP、LDL-C呈正相關(guān)(r=0.859,P0.01;r=0.491,P0.05;r=0.671,P0.01;r=0.229,P0.05),與HDL-C呈負(fù)相關(guān)(r=-0.293,P0.05)�！窘Y(jié)論】1.血清RBP4水平在冠心病組明顯高于對(duì)照組,AMI組、UAP組血清RBP4水平明顯高于SAP組,提示RBP4可能成為冠心病獨(dú)立危險(xiǎn)因素。2.冠脈病變支數(shù)越多,血清RBP4水平越高,且與Gensini積分呈正相關(guān),提示血清RBP4水平可反應(yīng)冠狀動(dòng)脈病變程度。3.血清RBP4水平可以作為評(píng)價(jià)冠心病患者病變嚴(yán)重程度及預(yù)后的參考指標(biāo)之一。
[Abstract]:[objective] to investigate the clinical significance of serum retinol binding protein 4 (RBP4) in the severity of coronary artery disease and its prognosis in patients with coronary heart disease. A total of 210 patients were diagnosed as coronary artery disease (CHD), including 69 patients with acute myocardial infarction, 35 patients with unstable angina pectoris and 56 patients with stable angina pectoris. According to the results of coronary angiography, the patients were divided into single vessel disease group (40 cases), double vessel disease group (63 cases), multivessel disease group (57 cases) and mild lesion group (36 cases) according to Gensini score. There were 46 cases in moderate lesion group, 44 cases in severe lesion group and 34 cases in very severe lesion group. The serum RBP4HCY and Hs-CRP were detected in all patients. The correlation between the level of RBP4 and the severity of coronary artery disease was analyzed. Patients with acute coronary syndrome were followed up by telephone or outpatient for 6 months. The correlation between the changes of serum RBP4 level and the incidence of major adverse cardiovascular events was analyzed. [results] 1.Compared with the control group, the level of serum RBP4HCYHs-CRP in the AMI group was significantly higher than that in the SAP group. 2. The level of serum RBP4HCYHs-CRP in the UAP group was significantly higher than that in the SAP group. There was no significant difference in serum RBP4 level between AMI group and UAP group. The level of serum RBP4HCYAHs-CRP in patients with double-vessel disease was significantly higher than that in control group (P 0.05). With the increase of the number of coronary artery lesion branches, the level of serum RBP4HCYHs-CRP was also significantly increased. The difference between the two groups was statistically significant (P 0.05). The serum RBP4 level increased gradually in the patients with severe and very severe lesions, and there was significant difference among the groups. There was a significant difference between the two groups. 5. ACS was based on the median value of serum RBP4 (28mg / L). The incidence of MACE in patients with ACS with RBP4 鈮，

本文編號(hào)：1554876