何卫斌++杨桂

[摘要] 目的 分析冠心病（CHD）患者血浆同型半胱氨酸（HCY）、白细胞介素-6（IL-6）、B型利钠肽（BNP）的水平及其与CHD病变程度的关系。 方法 选择2012年1月～2013年12月于河南省平顶山市第一人民医院确诊的CHD患者180例为CHD组，另选96例通过冠状动脉造影检查为正常者作为对照组。根据临床诊断分型将观察组CHD患者分为急性心肌梗死组（AMI组）68例，不稳定型心绞痛组（UAP组）72例和稳定性心绞痛组（SAP组）40例。检测并比较各组患者及不同类型CHD患者血浆HCY、IL-6、BNP的水平。 结果 CHD组HCY、IL-6、BNP水平均显著高于对照组，差异均有统计学意义（P < 0.05）；AMI组血HCY、IL-6、BNP明显高于UAP组，差异均有统计学意义（P < 0.05）。UAP组血HCY、IL-6、BNP明显高于SAP组，差异均有统计学意义（P < 0.05）。 结论 与正常人群比较，CHD患者血浆HCY、IL-6、BNP水平明显升高，不同类型CHD患者HCY、IL-6、BNP水平不同，三者联合可用来预测CHD及其危害程度。

[关键词] 冠心病；同型半胱氨酸；白细胞介素-6；B型利钠肽

[中图分类号] R541.4 [文献标识码] A [文章编号] 1673-7210（2015）05（b）-0050-04

Expression and clinical significance of the plasma HCY， IL-6 and BNP in patients with coronary heart disease

HE Weibin1 YANG Gui2

1.Department of Cardiology Medical， the First People's Hospital of Pingdingshan City， He'nan Province， Pingdingshan 467000， China； 2.Department of Laboratory， Zhongnan Hospital of Wuhan University， Hubei Province， Wuhan 430071， China

[Abstract] Objective To explore levels of the plasma HCY， IL-6 and BNP in patients with coronary heart disease and its relationship with coronary artery disease. Methods 180 patients with CHD diagnosed in the First People's Hospital of Pingdingshan City from January 2012 to December 2013 were selected as the CHD group， 96 cases of healthy subjects diagnosed by CAG were selected as the control group. Patients in CHD group were divided into AMI group （68 cases）， UAP group （72 cases） and SAP group （40 cases） according to the clinical diagnosis. Then the serum levels of IL-6， HCY and BNP in two groups and CHD patients with different types were tested and compared. Results The serum levels of IL-6， HCY and BNP in the CHD group were higher than those of the control group， the differences were statistically significant （P < 0.05）； the serum levels of IL-6， HCY and BNP in the AMI group were higher than those of the UAP group， the differences were statistically significant （P < 0.05）； the serum levels of IL-6， HCY and BNP in the UAP group was higher than those of the SAP group， the differences were statistically significant （P < 0.05）. Conclusion Compared with the normal people， the serum levels of IL-6， HCY and BNP in patients with CHD are obviously increased. Patients with different types of CHD has different levels of HCY， IL-6， BNP. The combination detection of the three indexes can be used in the prediction of coronary heart disease and the harm extent.

[Key words] Coronary heart disease； Homocysteine； Interleukin-6； Brain natriuretic peptide

冠心病（coronary heart disease，CHD）是临床工作中常见的危害健康的心血管疾病之一，近年来其发病率呈现上升趋势。及时判断CHD的病变危险程度尤为重要，目前尚缺乏敏感而又特异性的早期实验室检查方法。近年来国内外通过实验室检查以协助早期诊断CHD的方法越来越多，针对冠状动脉脉粥样硬化是一个缓慢的炎症性疾病过程[1-2]。可溶性白细胞介素-6（interleukin-6，IL-6）作为重要炎症因子之一，其参与CHD的病变关系越来越受到重视；相关研究表明，同型半胱氨酸（homocysteine，HCY）参与了动脉粥样硬化的病变过程，亦作为CHD的一个新型的独立的危险因素和易发因素为广大医学科研工作者所接受[3]；B型利钠肽（B-type natriuretic peptide，BNP），又称脑钠肽，是利钠肽家族成员之一，它升高与冠状动脉血管病变相关，反映心肌缺血程度、左室功能受损情况。本研究检测分析CHD患者HCY、IL-6和BNP的水平变化，探讨它们与冠状动脉病变程度的关系。……