[1]刘夏炎,余安运,于佩方,等.RDW,HCY和LP(a在高血压及冠心病中的临床应用[J].现代检验医学杂志,2017,32(04):80-82,86.[doi:10.3969/j.issn.1671-7414.2017.04.022]
　LIU Xia-yan,YU An-yun,YU Pei-fang,et al.Clinical Application of RDW,HCY and LP(a)in High Blood Pressure and Combined Coronary Heart Disease[J].Journal of Modern Laboratory Medicine,2017,32(04):80-82,86.[doi:10.3969/j.issn.1671-7414.2017.04.022]
点击复制

RDW,HCY和LP(a在高血压及冠心病中的临床应用()
分享到：

《现代检验医学杂志》[ISSN:/CN:]

卷:
第32卷
期数:
2017年04期
页码:
80-82,86
栏目:
论著
出版日期:
2017-07-25

文章信息/Info

Title:
Clinical Application of RDW,HCY and LP(a)in High Blood Pressure and Combined Coronary Heart Disease
文章编号:
1671-7414(2017)04-080-04
作者:
刘夏炎; 余安运; 于佩方; 王 娅
陕西省康复医院检验科,西安 710065
Author(s):
LIU Xia-yan; YU An-yun; YU Pei-fang; WANG Ya
Department of Clinical Laboratory,Shaanxi Kangfu Hospital,Xi'an 710065,China
关键词:
红细胞分布宽度;  同型半胱氨酸;  脂蛋白a;  冠心病
分类号:
R541.4; R446.112
DOI:
10.3969/j.issn.1671-7414.2017.04.022
文献标志码:
A
摘要:
目的 了解红细胞分布宽度(RDW-CV),血清同型半胱氨酸(HCY),脂蛋白[a(LP(a)]与高血压及冠心病(CHD)的相关性。探讨其在冠心病中的临床应用价值。方法 选择2014年3月～2017年4月在陕西省康复医院就诊的高血压患者563例,根据冠状动脉造影结果分为单纯性高血压组(62例)和高血压并发冠心病组(501例),另选正常对照组141例,比较三组的RDW-CV,HCY和LP(a)水平。再将冠心病组按心功能分级分为Ⅰ,Ⅱ,Ⅲ,Ⅳ四级,比较各组的RDW-CV水平,分析RDW-CV与心功能的相关性。结果 ①冠心病组RDW-CV,LP(a)和HCY水平分别为13.25%±1.22%,17.82±8.36 μmol/L,172.05±122.32 mg/L,高于高血压组(12.98%±0.57%,14.35±6.36 μmol/L,124.49±75.88 mg/L)和正常对照组(11.41%±2.85%,11.41±2.85 μmol/L,71.07±27.55 mg/L),差异均有统计学意义(P<0.05); ②其中RDW-CV和HCY与心功能分级呈正相关(r=0.461,0.197; P=0.000,0.032); ③ROC曲线下面积大小对冠心病诊断价值的排序为:HCY>LP(a)> RDW-CV。LP(a)灵敏度为82.5%,特异度为31.7%; RDW-CV灵敏度为48.8%,特异度为22.2%。结论高水平的RDW-CV,HCY和LP(a)与冠心病的发生密切相关; RDW-CV和HCY与冠心病及心功能损害的严重程度相关,可作为冠心病心功能发展程度的判定指标。
Abstract:
Objective Understanding of red blood cell distribution width(RDW-CV),blood homocysteine(HCY),lipoprotein a [LP(a)] a merger with high blood pressure and high blood,coronary heart disease(CHD)relevance and explore its clinical application value in CHD.Methods 563 cases of patients with high blood pressure were enrolled,which divided into 62 cases of primary hypertension,501 cases of hypertension combined withcoronary heart disease,according to the results of coronary angiography.141 normal cases were chosen as control group.Compared the three groups of RDW-CV,HCY and LP(a)level,the group of coronary artery disease was divided into Ⅰ,Ⅱ,Ⅲ and Ⅳ,and compared the RDW-CV level of each group,and the correlationbetween RDW and cardiac function was analyzed.Results ①Heart disease groups RDW-CV,LP(a)and HCY(13.25±1.22%,17.82±8.36 μmol/L,172.05±122.32 mg/L)were higher than blood pressure groups(12.98±0.57%,14.35±6.36 μmol/L,124.49±75.88 mg/L)and normal control group(11.41±2.85%,11.41±2.85 μmol/L,71.07±27.55 mg/L,P<0.05).②RDW-CV and HCY were positively correlated with the mental function classification(r=0.461,0.1970; P=0.000,0.032).③The area under the ROC curve was the order of the diagnostic value:HCY>LP(a)>RDW-CV.LP(a)sensitivity was 82.5% and specificity was 31.7%.RDW-CV sensitivity was 48.8% and specificity was 22.2%.Conclusion High levels of RDW-CV,HCY,and LP(a)wereclosely related to the occurrence of coronary heart disease; RDW-CV and HCY were related to the severity of coronary heart disease and cardiac function,and could be a potential biomarker for the development of cardiac function of coronaryheart disease.

参考文献/References:

[1] Felker GM,Allen LA,Pocock SJ,et al.Red cell distribution width as a novel prognostic marker in heart failure:data from the CHARM Program andthe Duke Databank[J].J Am Coil Cardiol,2007,50(1):40-47.
[2] 中华医学会心血管病学分会,中华心血管病杂志编辑委员会.中国心血管病预防指南[J].中华心血管病杂志,2011,39(1):3-22. Chinese Society of Cardiology of Chinese Medical Association,Editorial Board of Chinese Journal of Cardioolgy,Chinese guidelines for prevention ofcardiovascular disease[J].Chinese Journal of Cardiology,2011,39(1):3-22.
[3] 蒋雄京.高血压(4)高血压与冠心病(续3)[J].中国循环杂志,2012,27(3):168-169. Jiang XJ.High blood pressure(4)hypertension and coronary heart disease(3)[J].Chinese Circulation Journal,2012,27(3):168-169.
[4] Tsuboi S,Miyauchi K,Kasai T,et al.Impact of red blood cell distribution width on long-tern mortality in diabetic patients after percutaneous coronary intervention[J].Circulation Journal,2013,77(2); 456-461.
[5] Wen Y.High red blood cell distribution width is clo-sely associated with risk of carotid artery atherosclerosis in patients with hypertension[J].ExpClin Cardiol,2010,15(3):37-40.
[6] 程俊杰,李 静,梁西强,等.非高密度脂蛋白胆固醇与冠心病患者心功能分级的相关性研究[J].现代检验医学杂志,2016,31(3):43-47.Cheng JJ,Li J,Liang XQ,et al.Correlation between non high density lipoprotein cholesterol and cardiac function in patients with coronary heart disease[J].Journal of Modern Laboratory Medicine,2016,31(3):43-47.
[7] 赵 佳,左 林,姚创利,等.冠心病患者血清同型半胱氨酸水平与氧化应激的关系研究[J].现代检验医学杂志,2016,31(5):27-29. Zhao J,Zuo L,Yao CL,et al.Study on the relationship between serum homocysteine levels and oxidative stress in patients with coronary heart disease[J].Journal of Modern Laboratory Medicine,2016,31(5):27-29.
[8] Nordestgaard BG,Chapman MJ,Ray K,et al.Lipoprotein(a)as a cardiovascular risk factor:current status[J].Eur Heart J,2010,31(23):2844-2853.
[9] Khera AV,Cuchel M,de la Lere-Moya M,et al.Cholesterol efflux capacity, high-density lipoprotein function,and atherosclerosis[J].N Engl J Med,2011,364(2):127-135.

相似文献/References:

[1]赵 佳a,左 林b,姚创利a,等.锰超氧化物歧化酶基因变异 与血脂和同型半胱氨酸水平的关系研究[J].现代检验医学杂志,2016,31(03):12.[doi:10.3969/j.issn.1671-7414.2016.03.004]
　ZHAO Jiaa,ZUO Linb,YAO Chuang-lia,et al.Study on the Relationship between Manganese Superoxide Dismutase Gene Variants and the Levels of Blood Lipid and Homocysteine[J].Journal of Modern Laboratory Medicine,2016,31(04):12.[doi:10.3969/j.issn.1671-7414.2016.03.004]
[2]余安运,刘夏炎,宋 煜,等.血清脂蛋白(a)和同型半胱氨酸(HCY) 与2型糖尿病胰岛素抵抗的临床研究[J].现代检验医学杂志,2016,31(03):65.[doi:10.3969/j.issn.1671-7414.2016.03.018]
　YU An-yun,LIU Xia-yan,SONG Yu,et al.Clinical Study of Serum Lipoprotein(a) and Homocysteine with Type 2 Diabetes Mellitus and Insulin Resistance[J].Journal of Modern Laboratory Medicine,2016,31(04):65.[doi:10.3969/j.issn.1671-7414.2016.03.018]
[3]王兴宁,李 慧,米思蓉,等.脑梗死患者血清同型半胱氨酸水平与颈动脉粥样硬化的相关性研究[J].现代检验医学杂志,2015,30(03):46.[doi:10.3969/j.issn.1671-7414.2015.03.013]
　WANG Xing-ning,LI Hui,MI Si-rong,et al.Analysis of Relationship between Homocysteine and Carotid Atherosclerosis in Patients with Cerebral Infarction[J].Journal of Modern Laboratory Medicine,2015,30(04):46.[doi:10.3969/j.issn.1671-7414.2015.03.013]
[4]翟海军,朱晶.红细胞分布宽度对肺癌预后的临床分析[J].现代检验医学杂志,2015,30(06):147.[doi:10.3969/j.issn.1671-7414.2015.06.045]
　ZHAI Hai-jun,ZHU Jing.Clinical Analysis of Red Blood Cell Distribution Width on the Prognosis of Lung Cancer[J].Journal of Modern Laboratory Medicine,2015,30(04):147.[doi:10.3969/j.issn.1671-7414.2015.06.045]
[5]王伟伟,张 夏,黄传荣,等.血清LDH,TBIL,IBIL和Hcy水平检测 在MA和MDS临床鉴别诊断中的作用研究[J].现代检验医学杂志,2015,30(01):111.[doi:10.3969/j.issn.1671-7414.2015.01.031]
　WANG Wei-wei,ZHANG Xia,HUANG Chuan-rong,et al.Research on Detecting Serum LDH,TBIL,IBIL and Hcy Levels in Clinical Differential Diagnosis of MA and MDS[J].Journal of Modern Laboratory Medicine,2015,30(04):111.[doi:10.3969/j.issn.1671-7414.2015.01.031]
[6]赵 佳,左 林,姚创利,等.冠心病患者血清同型半胱氨酸水平与氧化应激的关系研究[J].现代检验医学杂志,2016,31(05):27.[doi:10.3969/j.issn.1671-7414.2016.05.007]
　ZHAO Jia,ZUO Lin,YAO Chuang-li,et al.Study on the Relationship between Serum Homocysteine Levels and Oxidative Stress in Patients with Coronary Heart Disease[J].Journal of Modern Laboratory Medicine,2016,31(04):27.[doi:10.3969/j.issn.1671-7414.2016.05.007]
[7]李 慧,贾良勇,冯 莉,等.阻塞性睡眠呼吸暂停低通气综合征并发脑梗死患者相关炎性指标的临床研究[J].现代检验医学杂志,2016,31(05):50.[doi:10.3969/j.issn.1671-7414.2016.05.013]
　LI Hui,JIA Liang-yong,FENG Li,et al.Clinical Studies of the Inflammatory Markers in Patients with Obstructive Sleep Apnea-Hypopnea Syndrom Complicated by Cerebral Infarction[J].Journal of Modern Laboratory Medicine,2016,31(04):50.[doi:10.3969/j.issn.1671-7414.2016.05.013]
[8]乔 军,毛华杰,白家瑞,等.西安地区同型半胱氨酸参考区间的初步建立[J].现代检验医学杂志,2016,31(05):130.[doi:10.3969/j.issn.1671-7414.2016.05.037]
　QIAO Jun,MAO Hua-jie,BAI Jia-rui,et al.Investigation on Serum Homocysteine for Reference Range in Xi'an[J].Journal of Modern Laboratory Medicine,2016,31(04):130.[doi:10.3969/j.issn.1671-7414.2016.05.037]
[9]郭进京,胡林辉,陶千山,等.红细胞分布宽度在多发性骨髓瘤患者预后分期中的价值[J].现代检验医学杂志,2017,32(03):34.[doi:10.3969/j.issn.1671-7414.2017.03.009]
　GUO Jin-jing,HU Lin-hui,TAO Qian-shan,et al.Value of Red Cell Distribution Width in the Prognosis of Patients with Multiple Myeloma[J].Journal of Modern Laboratory Medicine,2017,32(04):34.[doi:10.3969/j.issn.1671-7414.2017.03.009]
[10]何海洪,郭伟权,兰 希,等.严重生精障碍患者精子DNA碎片指数与血清Hcy水平的相关性研究[J].现代检验医学杂志,2017,32(04):83.[doi:10.3969/j.issn.1671-7414.2017.04.023]
　HE Hai-hong,GUO Wei-quan,LAN Xi,et al.Study on the Relationship between Sperm DNA Fragmentation Index and Hcy Level in Patients with Severe Spermatoqenesis[J].Journal of Modern Laboratory Medicine,2017,32(04):83.[doi:10.3969/j.issn.1671-7414.2017.04.023]

备注/Memo

备注/Memo:
作者简介:刘夏炎(1979-),女,本科,主管检验师,检验科副主任,主要从事生化及临床实验诊断的研究,E-mail: 674172600@qq.com。
更新日期/Last Update: 1900-01-01