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Hcy聯合CRP及WBC在冠心病患者中的診斷效果及價值研究

論文編號:lw201901161430376750 所屬欄目:醫學檢驗論文 發布日期:2019年01月16日 論文作者:論文網
【摘要】目的:觀察血清同型半胱氨酸(Hcy)聯合C反應蛋白(CRP)及白細胞(WBC)在冠心病患者中的診斷效果及價值。方法:選取2015年1月-2016年6月醫院診治的冠心病患者91例,設為觀察組。其中,急性心肌梗死(AMI)25例,不穩定心絞痛(UAP)24例,穩定性心絞痛(SPA)22例。選取同期入院健康體檢者33例,設為對照組。采用酶法檢測Hcy,采用免疫散射比濁法測定CRP水平,利用XE-5000全自動血液分析儀測定兩組WBC水平,分析Hcy聯合CRP及WBC在冠心病患者中的診斷效果。結果:觀察組患者Hcy聯合CRP及WBC水平,顯著高于對照組(P<0.05);急性心肌梗死、不穩定心絞痛和穩定性心絞痛Hcy聯合CRP及WBC水平,均高于對照組(P<0.05);急性心肌梗死Hcy聯合CRP及WBC水平,顯著高于不穩定心絞痛和穩定性心絞痛(P<0.05);不穩定心絞痛Hcy聯合CRP及WBC水平,顯著高于穩定性心絞痛(P<0.05);Hcy指標ROC曲線面積為0.84,CRP指標ROC曲線面積為1,WBC指標ROC曲線面積為0.96。結論:冠心病患者診斷過程中采用Hcy聯合CRP及WBC效果理想,能提高臨床確診率,值得推廣應用。
【關鍵詞】血清同型半胱氨酸;C反應蛋白;白細胞;冠心病;診斷效果;確診率
[Abstract] Objective: To observe the effect and value of homocysteine uniting with C reactive protein and white blood cell in the in patients with coronary heart disease. Method: Selecting 91 cases of coronary heart disease in the hospital from January 2015 to June 2016, they are set to  be the observation group. Among them, acute myocardial infarction in 25 cases, unstable angina pectoris in 24 cases, and stable angina pectoris in 22 cases. In the same period, 33 patients admitted to hospital were selected as control group. Enzyme assay was used to detect Hcy, and CRP level was measured by immune scatter turbidity method, Using XE-5000 automatic blood analyzer to measure the level of WBC in the two groups, to analyze the diagnostic effect of Hcy combined with CRP and WBC in patients with coronary heart disease. Results: The levels of CRP combined with WBC and Hcy in the observation group were significantly higher than those in the control group (P<0.05); Acute myocardial infarction, unstable angina and stable angina pectoris Hcy combined with CRP and WBC levels were higher than those in the control group (P<0.05); Hcy combined with CRP and WBC levels in patients with acute myocardial infarction was significantly higher than that in patients with unstable angina and stable angina pectoris (P<0.05); Hcy index ROC curve area was 0.84, CRP index ROC curve area was 1 and WBC index ROC curve area was 0.96. Conclusion: the diagnosis effect of coronary heart disease patients using Hcy combined with CRP and WBC is ideal, and it can improve the clinical diagnosis rate, so it is worth popularizing.
[Key words] serum homocysteine; C reactive protein; white blood cell; coronary heart disease; diagnosis effect; diagnosis rate
冠心病(coronary heart disease,CHD)是由于冠狀動脈發展粥樣硬化使得管腔狹窄或阻塞等,導致心肌缺血、缺氧等引起的心臟病。患者發病后病理變化進展相對較慢,病情較輕者臨床上缺乏特異性癥狀,病情較重者,將會引起心肌梗塞及猝死等,影響患者健康[1]。目前,臨床上對于冠心病主要以冠狀動脈造影診斷為主,且該方法一度被認為是冠心病的“金標準”[2]。但是,冠狀動脈造影檢查屬于是一種有創檢查,檢查費用相對較高,導致患者檢查依從性較差。因此,積極尋找一種簡便、易行、無創性檢查方法對提高臨床確診率具有重要的意義。近年來,Hc)聯合CRP及WBC在冠心病患者中得到應用,且效果理想[3]。為了探討血清同型半胱氨酸(Hcy)聯合C反應蛋白(CRP)及白細胞(WBC)在冠心病患者中的診斷效果及價值。選取2015年1月-2016年6月醫院診治的冠心病患者60例,報道如下。
1.資料與方法
1.1臨床資料
1.2 方法
1.3 觀察指標
2.結果
2.1 檢測四個指標在各組中的差異性
2.2 Hcy聯合CRP及WBC水平ROC曲線面積比較
3.討論

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