广西医学

目的探讨血清超敏C-反应蛋白（hs-CRP）、同型半胱氨酸（Hcy）联合颈动脉超声参数在冠心病患者冠状动脉狭窄程度评估中的应用价值。方法根据Gensini评分将98例冠心病患者分为轻度狭窄组（Gensini评分＜20分，n=32）和中重度狭窄组（Gensini评分≥20分，n=66）。比较两组患者的一般资料及血清hs-CRP水平、血清Hcy水平、颈动脉内膜中层厚度（IMT）、颈动脉斑块Crouse积分。采用Spearman相关法分析血清hs-CRP水平、血清Hcy水平及颈动脉超声参数与冠状动脉狭窄程度的相关性，采用受试者工作特征（ROC）曲线分析血清hs-CRP水平、血清Hcy水平及颈动脉超声参数单独及联合评估中重度冠状动脉狭窄的效能。结果中重度狭窄组血清hs-CRP水平、血清Hcy水平、颈动脉斑块Crouse积分、颈动脉IMT高于轻度狭窄组（P＜0.05）。Spearman相关分析结果显示，血清hs-CRP水平、血清Hcy水平、颈动脉斑块Crouse积分、颈动脉IMT与冠状动脉狭窄程度呈正相关（P＜0.05）。ROC曲线分析结果显示，血清hs-CRP水平、血清Hcy水平、颈动脉斑块Crouse积分、颈动脉IMT单独及其联合评估中重度冠状动脉狭窄的曲线下面积分别为0.847、0.768、0.884、0.783、0.986。结论血清hs-CRP水平、血清Hcy水平、颈动脉斑块Crouse积分、颈动脉IMT与冠心病患者冠状动脉狭窄程度相关，上述指标对中重度冠状动脉狭窄具有一定预测价值，且联合评估的预测价值相对更高。

ObjectiveTo investigate the application value of serum high-sensitivity C-reactive protein (hs-CRP) and homocysteine (Hcy) combined with carotid ultrasound parameters in the evaluation of coronary artery stenosis degree in patients with coronary heart disease.MethodsA total of 98 patients with coronary artery disease were divided into mild stenosis group (Gensini score＜20, n=32) or moderate-severe stenosis group (Gensini score≥20, n=66) according to Gensini score. The general data, serum hs-CRP level, serum Hcy level, carotid intima-media thickness (IMT), and carotid plaque Crouse score were compared between patients of the two groups. The correlation of serum hs-CRP level, serum Hcy level, and carotid ultrasound parameters with the degree of coronary artery stenosis was analyzed by using Spearman correlation method. The receiver operating characteristic (ROC) curve was used to analyze the efficiency of serum hs-CRP and Hcy levels, and carotid ultrasound parameters for alone and jointly evaluating moderate-severe coronary artery stenosis. ResultsSerum hs-CRP and Hcy levels, carotid plaque Crouse score, and carotid IMT in the moderate-severe stenosis group were higher than those in the mild stenosis group (P＜0.05). The results of Spearman correlation analysis revealed that serum hs-CRP and Hcy levels, carotid plaque Crouse score, and carotid IMT positively correlated with the degree of coronary artery stenosis (P＜0.05). The results of ROC curve analysis indicated that areas under the curve of serum hs-CRP and Hcy levels, carotid plaque Crouse score, carotid IMT for alone and jointly evaluating moderate-severe coronary artery stenosis were 0.847, 0.768, 0.884, 0.783, and 0.986, respectively. ConclusionSerum hs-CRP and Hcy levels, carotid plaque Crouse score, and carotid IMT correlate with the degree of coronary artery stenosis in patients with coronary heart disease, and these indicators exert a predictive value on moderate-severe coronary artery stenosis to a certain extent, and the combined evaluation exerts a relatively higher predictive value.