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D-二聚体、凝血指标和超敏C反应蛋白在冠心病患者中联合检测的临床意义

Clinical significance of combined detection of D-Dimer, coagulation four indices and hs-CPR level for coronary heart disease

摘要:

目的 探讨D-二聚体(D-D)、凝血四项和超敏C反应蛋白(hs-CRP)联合检测在不同类型冠心病(CHD)患者中的水平变化.方法 对67例冠心病患者进行血浆D-D、凝血四项和血清hs-CRP水平检测,其中稳定型心绞痛组(SA)22例、不稳定型心绞痛组(UA)20例和急性心肌梗死组(AMI) 25例;健康人(对照组)20例.另根据患者冠状动脉造影结果将CHD患者分为单支病变组21例、双支病变组23例和三支病变组23例,分别测定并比较各组患者D-D、凝血四项和hs-CRP水平.结果 D-二聚体(D-D)、纤维蛋白原(FIB)及超敏C反应蛋白(hs-CRP)在四组(AMI组、UA组、SA组、对照组)间比较,差异均有统计学意义(P<0.01);UA组与SA组、对照组间D-D、FIB及hs-CRP比较,差异均有统计学意义(P<0.05);与对照组的hs-CRP相比,SA组组间差异具有统计学意义(P<0.01);各组之间的PT、APTT和TT的比较,差异均无统计意义(P>0.05);冠状动脉单支病变组、双支病变组和三支病变组患者D-D、FIB及hs-CRP水平显著高于NC组(P<0.05);冠状动脉3支病变组患者D-D、FIB及hs-CRP水平显著高于双支病变组和单支病变组(P<0.05),冠状动脉双支病变组患者D-D、FIB及hs-CRP水平显著高于单支病变组(P<0.05).各组之间的PT、APTT和TT的比较,差异均无统计意义(P>0.05).结论 D-二聚体(D-D)、纤维蛋白原(FIB)和超敏C反应蛋白(hs-CRP)水平的的升高与冠脉病变的程度有着密切的联系,并且对冠心病的类型预测有一定的临床指导意义.

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Objective To explore the clinical value of combined detection of D-dimer,coagulation four indices and hs-CRP in diagnosis of coronary heart disease (CHD).Methods D-Dimer,coagulation four indices and hsCPR level were detected in 67 patients with CHD[22 stable angina(SA) pectoris patients,20 unstable angina (UA) pectoris patients and 25 acute myocardial infarction (AMI) patients] and 20 healthy people(normol control group).According to the result of coronary arteriongraphy,the patients with CHD were divided into single vessel disease group (n =21),double vessel disease group (n =23) and three vessel disease group (n =23).The levels of plasma D-D,fibrinogen(FIB) and hs-CRP were detected and compared.Results Compared with UA group,SA group,control group respectively,D-D,fibrinogen and hs-CRP level of AMI group had statistical significance (P < 0.01) ;Compared with SA group,control group,D-D,fibrinogen and hs-CRP level of UA group had statistical significance (P < 0.05) ;Compared with control group,hs-CRP level of SA group had statistical significance (P < 0.01).The comparision of PT,APTT and TT level between each two groups,there was no statistical difference (P > 0.05).The levels of plasma DD and FBG in single vessel disease group,double vessel disease group and three vessel disease group were significantly higher than those in NC group(P < 0.05).The levels of plasma DD and FBG in three vessel disease group were significantly higher than those in single vessel disease group and double vessel disease group(P < 0.05).The levels of plasma DD and FBG in double vessel disease group were significantly higher than those in single vessel disease group (P < 0.05).The comparision of PT,APTT and TT level between each two groups,there was no statistical difference (P > 0.05).Conclusion The level of D-D,FIB and hs-CRP have close relationship with the severe degree of CHD and can help clinical doctor to predict the type of CHD.

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