目的:探析血清超敏肌钙蛋白T (hscTnT) 、同型半胱氨酸(Hcy) 、超敏C反应蛋白(hsCRP)联合检测与冠心病诊断阳性率的相关性.方法:选择95例冠心病患者,其中稳定型心绞痛(SAP) 35例,不稳定型心绞痛(UAP) 30例,急性心肌梗死(AMI) 30例.根据冠脉造影结果,患者被分为:轻度狭窄组(31例),中度狭窄组(34例)和重度狭窄组(30例),并另选95例健康体检者作为健康对照组.检测并比较各组hscTnT 、 Hcy 、 hsCRP水平及单独检测和联合检测的阳性率,并分析冠状动脉病变程度与血清hscTnT 、 Hcy 、 hsCRP水平及联合检测的相关性.结果:冠心病患者的血清hscTnT 、 Hcy 、 hsCRP水平均显著高于健康对照组( P均＝ 0.001 ).UAP与AMI组的Hcy阳性率明显高于SAP组(63.33%、70.00% 比14.29%,P均＝0.001).SAP、 UAP及AMI患者的联合检测阳性率(91.43%、 93.33%、 96.67%)之间无统计学意义(P均＞0.05),但均显著高于单一指标阳性率(P＜0.05或＜0.01).hscTnT与hsCRP诊断SAP的阳性率显著高于 Hcy (68.57%、 71.43% 比14.29%,P均＝0.001).与轻度狭窄组比较,中度、重度狭窄组患者的血清hscTnT 、Hcy、hsCRP水平明显升高,且重度狭窄组的明显高于中度狭窄组的(P均＝0.001).二变量Spearman分析显示,冠心病患者血清hscTnT、Hcy、hsCRP水平及联合检测结果与冠状动脉病变程度之间均呈明显正相关(r＝ 0.512～0.813,P均＜ 0.01).结论:冠心病患者的血清hscTnT 、 Hcy 、 hsCRP联合检测阳性率均高于单一指标阳性率,联合诊断结果与冠脉病变程度呈明显正相关.%Objective:To explore the correlation between combined detection of serum high sensitive troponin T (hscTnT),homocysteine (Hcy) and high sensitive C reactive protein (hsCRP) and diagnostic positive rates of coro-nary heart disease (CHD).Methods:A total of 95 CHD patients were selected,including 35 cases with stable angina pectoris (SAP),30 cases with unstable angina pectoris (UAP) and 30 cases with acute myocardial infarction (AMI).According to results of coronary angiography,patients were divided into mild stenosis group (n＝31),moderate ste-nosis group (n＝34) and severe stenosis group (n＝30).Another 95 healthy subjects were enrolled as healthy control group.Levels of hscTnT,Hcy and hsCRP were measured and compared among all groups,positive rates of single and combined detection were measured,and correlation among coronary disease severity,serum levels of hscTnT,Hcy,hsCRP and their combined detection were analyzed.Results:Serum levels of hscTnT,Hcy and hsCRP in CHD group were significantly higher than those of healthy control group,P＝0.001 all.Hcy positive rates of UAP and AMI group were significantly higher than that of SAP group (63.33%,70.00% vs.14.29%,P＝0.001 all).There was no significant difference in positive rate of combined detection (91.43%,93.33%,96.67%) among SAP group,UAP group and AMI group ( P＞0.05 all),but all of them were significantly higher than those of single de-tection,P＜0.05 or ＜ 0.01.Positive rates of hscTnT and hsCRP diagnosing SAP were significantly higher than that of Hcy (68.57%,71.43% vs.14.29%,P＝0.001 all).Compared with mild stenosis group,there were signifi-cant rise in serum levels of hscTnT,Hcy and hsCRP in moderate and severe stenosis group,and those of severe ste-nosis group were significantly higher than those of moderate stenosis group (P＝0.001 all).Biviarate Spearman a-nalysis indicated that serum levels of hscTnT,Hcy and hsCRP,their combined detection results were significant pos-itively correlated with coronary disease severity in CHD patients (r＝0.512～0.813,P＜0.01 all).Conclusion:Pos-itive rate of combined detection of serum hscTnT,Hcy and hsCRP is significantly higher than those of single detec-tion in CHD patients.Combined diagnostic result is significant positively correlated with coronary disease severity.
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