铁蛋白和同型半胱氨酸水平对冠心病预测价值.docVIP

铁蛋白和同型半胱氨酸水平对冠心病预测价值 　　[摘要]目的探讨血清铁蛋白（SF）和血浆同型半胱氨酸（Hcy）水平对冠心病（CHD）及病变类型的预测价值。方法选择行冠状动脉造影的患者145例，根据造影结果分为冠心病组（CHD组）和非冠心病（NCHD）组；CHD组根据动脉病变类型分为单支、双支和三支病变组测定SF、Hcy和血脂水平，进行统计学分析。结果CHD组SF和Hcy水平显著高于NCHD组（P0.01），不同动脉病变组SF水平均高于NCHD组（P0.01）。除单支病变组与NCHD组比较Hcy差异无统计学意义外，其余病变组Hcy水平均高于NCHD组（P0.05）。SF与CHD的发病密切相关（OR=1.01，P0.01）。SF预测CHD的ROC曲线下面积为0.83，95%的可信区间为0.76～0.89（P0.01），Hcy预测CHD的ROC曲线下面积为0.64，95%的可信区间为0.55～0.73（P0.01）。结论SF升高是CHD的另一独立危险因素，CHD患者的Hcy较NCHD组高，测定血浆SF和Hcy的水平对CHD的预测有一定临床意义。 　　[关键词]冠心病；血清铁蛋白；血浆同型半胱氨酸 　　中图分类号：R541.4文献标识码：A文章编号：1009_816X（2014）04_0284_03 　　[Abstract] Objective To discuss the predictive value of homocysteine and serum ferritin （SF） for coronary heart disease. Methods 145 patients underwent coronary angiography were enrolled and divided into CHD group and the none_CHD（NCHD） group by the results. The CHD group were divided into single branch group， two branches group and three branches group according to the types of arterial disease. SF， Hcy and blood_lipoids were detected， and then processed statistical analysis. Results CHD group had higher concentration of SF and Hcy than none_CHD group （P0.01）.The two and three branches groups had higher level of SF and Hcy than NCHDgroup （P0.05），while the single branch group had only statistically different in SF compared to NCHD group. SF had a close correlation with CHD （OR=1.01， P0.01）. Furthermore， receiver operating characteristic （ROC） curves were used to analyze the ability of SF and Hcy to discriminate CHD.The area under ROC curves of SF predicting CHD was 0.826 （95% confidence interval=0.760～0.892， P0.01） as well as Hcy was 0.644 （95% confidence interval=0.554～0.734， P0.01）. Conclusions SF is another important risk factor of CHD. Patients with CHD always have high level of Hcy. These results suggest that measurement of SF and Hcy could be of great assistance in predicating CHD. 　　[Key words] Coronary heart disease； Serum ferritin； Homocysteine 　　根据世界卫生组织2011年的报告，心血管疾病是全球人类死亡的头号杀手，其中冠心病（Coronary heart dis