【摘要】：目的:研究血清胱抑素C(Cys-C)、紅細胞分布寬度(RDW)水平與冠心病(CHD)及冠脈血管病變嚴重程度的相關(guān)性,旨在為CHD的預(yù)測及診治提供一些參考性的依據(jù)。方法:選擇2014年10月-2016年6月于陜西省西安市西安醫(yī)學(xué)院第二附屬醫(yī)院心血管內(nèi)科收治的經(jīng)排除標準篩選后行經(jīng)皮冠狀動脈造影術(shù)的對象116例,其中確診為CHD的患者72例為病例組,根據(jù)冠狀動脈造影結(jié)果顯示的病變支數(shù)將病例組分為單支病變亞組(32例)、雙支病變亞組(20例)、多支病變亞組(20例);根據(jù)Gensini評分將病例組分為低分組、中分組、高分組,分別為34例、18例、20例,另外冠狀動脈造影正常者44例,作為對照組;所有研究對象均于入院時行血清Cys-C、RDW水平檢測,對數(shù)據(jù)進行整理、分析,觀察兩組在Cys-C及RDW水平中的差異,并研究Cys-C及RDW水平與CHD發(fā)生及血管病變嚴重程度是否具有一定相關(guān)性。結(jié)果:病例組中Cys-C、RDW水平分別為(0.995±0.238)mg/L、(12.758±0.554)%,均高于對照組(0.847±0.146)mg/L、(12.495±0.510)%,與對照組相比差異有統(tǒng)計學(xué)意義(p0.05)。病例組中單支、雙支、多支病變亞組Cys-C水平分別為(0.904±0.238)mg/L、(1.032±0.097)mg/L、(1.179±0.138)mg/L,組間比較,差異有統(tǒng)計學(xué)意義(p0.05);單支、雙支、多支病變組RDW水平比較,分別為(12.422±0.236)%、(12.715±0.528)%、(13.035±0.427)%,差異有統(tǒng)計學(xué)意義(p0.05);病例組Gensini評分低分組、中分組、高分組Cys-C水平分別為(0.906±0.226)mg/L、(1.036±0.101)mg/L、(1.186±0.141)mg/L,Cys-C水平與Gensini評分呈正相關(guān)(r=0.616,p0.001);Gensini評分低分組、中分組、高分組RDW水平分別為(12.429±0.234)%、(12.722±0.574)%、(13.045±0.392)%,RDW水平與Gensini評分呈正相關(guān)(r=0.581,p0.001)。結(jié)論:Cys-C、RDW水平的改變可介導(dǎo)炎癥反應(yīng),造成血管重建,可能是促進動脈粥樣硬化(AS)形成的重要因素,從而導(dǎo)致CHD的發(fā)生及發(fā)展。通過此次研究發(fā)現(xiàn)Cys-C及RDW水平的增加可對診斷CHD及CHD血管病變嚴重程度進行預(yù)測提供依據(jù)。
[Abstract]:Aim: to study the correlation of serum cystatin C (Cys-C) and red blood cell distribution width (RDW) levels with (CHD) and severity of coronary artery disease (CAD) in order to provide some references for the prediction, diagnosis and treatment of CHD. Methods: from October 2014 to June 2016, 116 patients who underwent percutaneous coronary angiography (PTCA) were selected from the Department of Cardiovascular Medicine, the second affiliated Hospital of Xi'an Medical College, Xi'an City, Shaanxi Province. According to the number of coronary artery angiography, 72 patients with CHD were divided into three groups: single vessel lesion subgroup (32 patients), double vessel lesion subgroup (20 patients) and multi-vessel lesion subgroup (20 patients). The patients were divided into three groups: single vessel lesion subgroup (n = 32), double vessel lesion subgroup (n = 20) and multi-vessel lesion subgroup (n = 20). According to the Gensini score, the patients were divided into low group, middle group and high group, which were 34 cases, 18 cases, 20 cases respectively, and 44 cases of normal coronary angiography were used as control group. All the subjects were tested for serum Cys-C,RDW level at admission, the data were analyzed, and the differences in Cys-C and RDW levels between the two groups were observed. The levels of Cys-C and RDW were correlated with the occurrence of CHD and the severity of angiopathy. Results: the level of Cys-C,RDW in the patient group was (0.995 鹵0.238) mg/L, (12.758 鹵0.554)%, which was higher than that in the control group (0.847 鹵0.146) mg/L, (12.495 鹵0.510)%. Compared with the control group, the difference was statistically significant (p0.05). In the case group, the levels of Cys-C were (0.904 鹵0.238) mg/L, (1.032 鹵0.097) mg/L, (1.179 鹵0.138) mg/L, respectively, and the difference was statistically significant (p0.05). The levels of RDW were (12.422 鹵0.236)%, (12.715 鹵0.528)%, (13.035 鹵0.427)% in single, double and multiple vessel groups, respectively. The difference was statistically significant (p0.05). The level of Cys-C was (0.906 鹵0.226) mg/L, (1.036 鹵0.101) mg/L, (1.186 鹵0.141) mg/L,Cys-C in the case group and (0.906 鹵0.226) mg/L, in the middle group and (1.186 鹵0.141) mg/L,Cys-C in the high group respectively. There was a positive correlation between the level of Gensini and the Gensini score (r = 0.616, P < 0.01). P0.001); Gensini scores in low, middle and high groups were (12.429 鹵0.234)%, (12.722 鹵0.574)%, (13.045 鹵0.392)%, respectively. There was a positive correlation between RDW level and Gensini score (r = 0.581, p0.001). Conclusion: the change of Cys-C,RDW level may mediate inflammatory reaction and result in vascular remodeling, which may be an important factor in promoting the formation of (AS) in atherosclerosis, thus leading to the occurrence and development of CHD. It was found that the increased levels of Cys-C and RDW could be used to predict the severity of vascular lesions in CHD and CHD.
【學(xué)位授予單位】：西安醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R541.4

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