摘要
目的 :探讨血浆D 二聚体水平与冠心病 (CHD)及其危险因素的关系。方法 :检测经冠状动脉造影证实的 6 7例CHD患者和 4 3例健康对照者的D 二聚体水平 ,以性别 ,年龄 ,体重指数 (BMI) ,是否并发高血压、糖尿病、CHD家族史 ,白细胞计数、总胆固醇 (TC)、三酰甘油 (TG)、高密度脂蛋白胆固醇 (HDL L)、低密度脂蛋白胆固醇 (LDL C)、血清同型半胱氨酸 (Hcy)、尿酸、纤维蛋白原 (Fib)浓度、血清高敏感C反应蛋白 (hs CRP)水平为危险因素 ,进行统计分析。结果 :CHD组的D 二聚体水平为 ( 338.5 2± 15 6 .92 ) μg/L ,对照组为 ( 2 2 1.72± 4 2 .0 2 ) μg/L ,两者之间差异有统计学意义 (P <0 .0 5 )。采用多样本的秩和检验发现稳定型心绞痛 (SAP)、不稳定型心绞痛(UAP)、陈旧性心肌梗死 (OMI)、急性心肌梗死 (AMI)患者的D 二聚体水平之间差异均有统计学意义 (均 P <0 .0 1) ,AMI患者最高 ,依次为AMI >UAP >SAP和OMI≥对照者。与血浆D 二聚体水平具有等级相关关系的因素有年龄、BMI、吸烟量、Fib、Hcy、hs CRP、并发高血压和糖尿病。逐步多元回归分析发现只有年龄、Hcy和hs CRP与D 二聚体独立相关 ,Fib与其有独立相关的趋势。结论 :CHD患者血浆D 二聚体水平明显增高 ,不同类型的CHD患者的血浆D 二聚体水平也不同 ;
Objective:To investigate the relationship between plasma D dimer and coronary heart disease(CHD) and explore its association with traditional risk factors of CHD.Methods:Plasma D dimer was measured by enzyme linked immunosorbent assay (ELISA) in patients with CHD confirmed by coronary artery angiography and 43 healthy control subjects matched for sex and age . Gender, age, body mass index(BMI), total cholesterol,white blood cell count(WBC), triglyceride, high density lipoprotein cholesterol (HDL C), low density lipoprotein cholesterol(LDL C), serum homocysteine(Hcy), serum high sensitive C reactive protein(hs CRP), fibrinogen(Fib), cigarette consumption, the complications of primary hypertension or diabetes, and CHD family history were analyzed.Results:The plasma levels of D dimer in CAD patients[( 338.52 ± 156.92 )μg/L] were significantly higher than that in the normal controls[( 221.72 ± 42.02 )μg/L] by using a rank sum test analysis(P< 0.05 ). The patients of stable angina pectoris(SAP), unstable angina pectoris(UAP), old myocardial infarction(OMI) or acute myocardial infarction(AMI) have different D dimer levels (P< 0.01 ). AMI patients have the highest D dimer level and the controls have the lowest level(AMI>UAP>SAP or OMI≥controls). With a spearman rank correlation analysis, age, BMI, Hcy, hs CRP, Fib, cigarette smoking consumption, the complications of primary hypertension or diabetes showed a positive correlation to D dimer. Stepwise multiple regressions showed age, Hcy and hs CRP were independently related to D dimer and Fib presented a tendency of independent correlation to D dimer.Conclusion:D dimer is not only a risk factor of CHD but also a marker of the severities of CHD. Age, Hcy and hs CRP have a positive association with plasma D dimer.
出处
《临床心血管病杂志》
CAS
CSCD
北大核心
2004年第2期83-85,共3页
Journal of Clinical Cardiology
