冠心病与cYcs.docVIP

胱抑素 C 与冠心病的相关性研究 孙 磊△，杨志健，贾恩志 （南京医科大学第一附属医院心内科，江苏 南京 210029） ［摘 要］ 目的：研究血清胱抑素 C（Cys C）与冠心病的相关性。 方法：回顾性分析 525 例高度怀疑冠心病而行冠脉造影患者的临床资料，从冠心病病情程度、冠脉病变支数和冠脉病变 Gensini 总积分 3 方面研究血清 Cys C 水平与冠心病之间的关系。应用 免疫比浊法检测血清 Cys C 浓度，对 Cys C 水平与冠心病病情、冠脉病变程度和冠脉病变 Gensini 总积分进行单因素和多因分析。结果：①随着血清 Cys C 水平的升高，冠心病患者病情逐渐加重，冠脉病变支数和 Gensini 总积分增加；在急性心梗时由于急性时相反应血清 Cys C 水平出现下降；②Logistic 回归结果显示 Cys C 与冠脉有无病变显著相关（OR 值 5．346，95％ CI 为2．225～12．846，P ＜ 0．01）；③多元逐步回归结果显示在校正了年龄、性别等因素之后，Cys C 与冠脉病变 Gensini 总积分（β ＝ 0．149，P ＜ 0．01） 仍然独立相关。 结论：血清 Cys C 水平与冠心病有密切关系。 随着血清 Cys C 水平升高，冠心病患者病情逐渐加重，冠脉病变程度也更加严重。 ［关键词］ 胱抑素； 冠状动脉疾病； 冠状动脉造影 ［中图分类号］ R643．5 ［文献标识码］ A ［文章编号］ 1007-4368（2009）05-0702-06 Association of cystatin C and coronary heart disease SUN Lei△，YANG Zhi-jian，JIA En-zhi （Department of Cardiology，the First Affiliated Hospital of NJMU，Nanjing 210029，China） ［Abstract］ Objective：To investigate the relationship between serum levels of cystatin C and severity of coronary heart disease（CHD）． Methods：Five hundred and twenty-five patients with CHD who underwent coronary angiography were selected in the study．The relationship between serum levels of cystatin C and the pathogenetic condition of CHD，the number of diseased vessels and theCHD Gensini cumulative index was evaluated． Serum levels of cystatin C was measured by nephelometric immunoassay． All data wereanalyzed by univariate and multivariate analyses． Results： ①With the increase of serum levels of cystatin C，the pathogenetic condition in patients with CHD became more serious，the number of diseased vessels and the CHD Gensini cumulative index increased．Due tothe reaction at the acute phase of acute myocardial infarction（AMI），the serum levels of cystatin C decreased；②Further logistic re-gression analysis indicated that cystatin C had significant correlation with pathological changes of coronary artery（OR was 5．346，95％CI ＝ 2．225～12．846，P ＜ 0．01）； ③After adjusting the influencing factors such as age，sex and so on，multivariable stepwise regressionanalysis showed