摘要
目的探讨冠心病(CHD)合并心衰(HF)患者血清高密度脂蛋白胆固醇(HDL-C)、C反应蛋白(CRP)水平变化与临床心功能分级及易损斑块的关系。方法选取本院2021年1月~2023年6月收治的103例CHD合并HF患者,采用直接测定法及免疫比浊法检测患者入院时血清HDL-C、CRP水平。根据美国心脏病协会(NYHA)心功能分级标准将患者心功能分为Ⅰ~Ⅱ级、Ⅲ级、Ⅳ级;所有患者进行光学相干断层成像(OCT)检查,根据检查结果的斑块性质将患者分为易损组和稳定组,比较不同心功能分级及不同斑块性质患者的血清HDL-C、CRP水平变化情况;采用Spearman相关性分析法分析血清HDL-C、CRP水平与CHD合并HF患者心功能分级及冠状动脉易损斑块的相关性。结果不同心功能分级患者血清HDL-C、CRP水平比较差异有统计学意义(P<0.05),其中HDL-C比较:Ⅰ~Ⅱ级>Ⅲ级>Ⅳ级(P<0.05),CRP比较:Ⅰ~Ⅱ级<Ⅲ级<Ⅳ级(P<0.05)。易损组血清HDL-C水平较稳定斑块组低(P<0.05),CRP水平较稳定组高(P<0.05)。Spearman相关性分析显示,血清HDL-C水平与心功能分级、易损斑块呈负相关(r=-0.758、-0.788,P<0.05),血清CRP水平与心功能分级、易损斑块呈正相关(r=0.883、0.862,P<0.05)。结论CHD合并HF患者血清HDL-C、CRP水平与其心功能分级及易损斑块的发生紧密相关,血清HDL-C水平越低、CRP水平越高,心功能受损程度及斑块易损风险越高。
Objective To investigate the relationship between the changes in serum high-density lipoprotein cholesterol(HDL-C)and C-reactive protein(CRP)levels and clinical heart function grade and vulnerable plaque in patients with coronary heart disease(CHD)complicated with heart failure(HF).Methods 103 patients with CHD complicated with HF admitted to our hospital from Jan 2021 to Jun 2023 were selected,and the serum HDL-C and CRP were measured by direct measurement and immunoturbidimetry.Patients were classified into gradesⅠ~Ⅱ,gradeⅢand gradeⅣaccording to the American Heart Association(NYHA);all patients underwent optical coherence tomography(OCT)examination,and divided into vulnerable and stable groups based on the plaque properties.and compared the changes in serum HDL-C and CRP with different functional levels and plague properties.The Spearman correlation analysis was used to analyze the correlation between serum HDL-C、CRP,heart function grading,and rulnerable coronary artery plagues in patients with CHD complicated with HF.Results Significant variations were observed in serum HDL-C and CRP levels across different heart function grades(P<0.05).Specifically,HDL-C levels exhibited a decreasing trend from gradeⅠtoⅡ>gradeⅢ>gradeⅣ(P<0.05),while CRP levels demonstrated and increasing trend from gradeⅠtoⅡ<gradeⅢ<gradeⅣ(P<0.05).In the vulnerable group,serum HDL-C was lower than that in the stable plague group(P<0.05),and CRP levels were higher(P<0.05).Spearman correlation analysis indicated a negative correlation between serum HDL-C levels and cardiac function grade as well as vulnerable plaque(r=-0.758,-0.788,P<0.05),while serum CRP levels showed a positive correlation with cardiac function grade and vulnerable plaque(r=0.883,0.862,P<0.05).Conclusion Serum levels of HDL-C and CRP in patients with CHD complicated by HF exhibit a significant correlation cardiac function grade and vulnerable plaque occurrence.Lower HDL-C levels correspond to higher CRP levels,indicating a heightened degree of the cardiac function impairment and the risk of plaque vulnerability.
作者
张学辉
林玉兰
Zhang Xuehui;Lin Yulan(Internal Department 2,Jiaozuo Coal Industry(Group)Co.,Ltd.Central Hospital Branch 1,Jiaozuo 454000)
出处
《中国现代医药杂志》
2024年第1期33-37,共5页
Modern Medicine Journal of China
关键词
冠心病合并心力衰竭
高密度脂蛋白胆固醇
C反应蛋白
心功能
易损斑块
相关性
Coronary heart disease complicated with heart failure
High density lipoprotein cholesterol
Creactive protein
Cardiac function
Vulnerable plaque
Correlation
