本文選題：冠心病 + s�。� 參考：《南華大學》2015年碩士論文

【摘要】：研究背景及目的探討不同類型冠心病患者血清可溶性核因子K-B受體活化因子配體(Soluble nuclear factor K-B receptor activation factor ligands,s RANKL)水平變化,以及血清s RANKL水平與Hs-CRP、超敏肌鈣蛋白T、γ-谷氨酰轉肽酶水平、GRACE評分和冠狀動脈Gensini積分的相關性。方法抽血以ELISA法測定27例穩(wěn)定性冠心病組和43例急性冠脈綜合征(ACS)組患者(其中不穩(wěn)定型心絞痛(UA)患者24例,急性心肌梗死(AMI)患者19例)及20例非冠心病對照組患者血清s RANKL水平,同時觀察s RANKL水平與Hs-CRP、超敏肌鈣蛋白T、γ-谷氨酰轉肽酶、GRACE評分和冠狀動脈Gensini積分的相關性。結果3組患者平均年齡、男女比例、體重指數(shù)、收縮壓、舒張壓、血脂、肌酐等臨床基本資料比較差異均無統(tǒng)計學意義(P0.05),提示3組患者具有可比性。急性冠脈綜合征組患者的血清s RANKL水平比穩(wěn)定性冠心病組和非冠心病對照組顯著降低(P0.01),其中,非冠心病對照組、穩(wěn)定性冠心病組和急性冠脈綜合征組的血清s RANKL水平分別為0.153±0.014、0.152±0.0156、0.143±0.014 ng/ml。亞組分析顯示急性心肌梗死亞組和不穩(wěn)定心絞痛亞組患者血清s RANKL水平與穩(wěn)定性冠心病組和非冠心病對照組相比,均有明顯降低(P0.05)。穩(wěn)定性冠心病組患者血清s RANKL水平與非冠心病對照組相比差異沒有統(tǒng)計學意義(P0.05)。ACS組患者血清γ-谷氨酰轉肽酶、c Tn T和hs-CRP水平均高于穩(wěn)定性冠心病和非冠心病對照組(P0.05),相關性檢驗顯示血清γ-谷氨酰轉肽酶和c Tn T水平與患者GRACE評分成正相關(P0.05),同時與冠狀動脈Gensini積分也成正相關(P0.05)。血清s RANKL和Hs-CRP水平與患者GRACE評分和冠狀動脈Gensini積分都無明顯相關(P0.05)。而血清s RANKL水平與γ-谷氨酰轉肽酶、c Tn T、hs-CRP水平都未顯示出明顯相關性(P0.05)。結論1)與非冠心病對照組和穩(wěn)定性冠心病組相比,急性冠脈綜合征組患者的血清s RANKL水平降低;血清γ-谷氨酰轉肽酶、c Tn T和hs-CRP水平明顯高于穩(wěn)定性冠心病和非冠心病對照組;2)s RANKL聯(lián)合其他血清學指標或聯(lián)合GRACE評分可能能更有效預測冠心病危險分層。
[Abstract]:Background and objective to investigate the changes of serum soluble nuclear factor K-B receptor activating factor ligand (Soluble nuclear factor K-B receptor activation factor ligand sRANKL) in patients with coronary heart disease (CHD). The correlation of serum s RANKL level with Hs-CRP, T, 緯 -glutamyl transpeptidase (GRACE) score and Gensini score of coronary artery was also studied. Methods 27 stable coronary heart disease patients and 43 acute coronary syndrome patients (including 24 patients with unstable angina pectoris) were measured by ELISA method. The serum s RANKL levels were observed in 19 patients with acute myocardial infarction (AMI) and 20 patients without coronary heart disease (control group). The correlation of s RANKL levels with Hs-CRP, T, GRACE score and Gensini score of coronary artery was also observed. Results there were no significant differences in average age, ratio of male and female, body mass index, systolic blood pressure, diastolic blood pressure, blood lipids and creatinine between the three groups. The serum s RANKL levels in the patients with acute coronary syndrome were significantly lower than those in the stable coronary heart disease group and the non-coronary heart disease group. The serum s RANKL levels in the non-coronary heart disease control group, the stable coronary heart disease group and the acute coronary syndrome group were 0.153 鹵0.014 0.152 鹵0.0156 鹵0.143 鹵0.014 ng / ml, respectively. Subgroup analysis showed that the serum s RANKL levels in patients with acute myocardial infarction (AMI) and unstable angina pectoris (UAP) were significantly lower than those in patients with stable coronary heart disease (CHD) and control group (non-CHD). There was no significant difference in serum s RANKL levels between stable coronary heart disease group and control group. The serum levels of 緯 -glutamyl transpeptidase c TnT and hs-CRP in stable coronary heart disease group were higher than those in stable coronary heart disease group and non-coronary heart disease group. The correlation test showed that the serum levels of 緯 -glutamyl transpeptidase and c Tn T were positively correlated with the GRACE score and the Gensini score of the coronary artery. There was no significant correlation between serum s RANKL and Hs-CRP levels and GRACE score and Gensini score of coronary artery (P 0.05). The levels of serum s RANKL and 緯 -glutamyl transpeptidase c Tn TnTnhs-CRP did not show any significant correlation (P 0.05). Conclusion 1) compared with the control group and the stable coronary heart disease group, the serum s RANKL level in the patients with acute coronary syndrome was lower than that in the control group. The levels of serum 緯 -glutamyl transpeptidase C T and hs-CRP were significantly higher than those in stable coronary heart disease (CHD) and non-coronary heart disease (CHD) control groups combined with other serological indexes or GRACE scores, which might be more effective in predicting risk stratification of coronary heart disease (CHD).
【學位授予單位】：南華大學
【學位級別】：碩士
【學位授予年份】：2015
【分類號】：R541.4

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