杨怀宇,
刘长河,
郑振国^,
大连大学附属中山医院 心内科, 辽宁 大连 116011

详细信息 作者简介: 杨怀宇(1992-), 男, 硕士研究生。E-mail: 1070008015@qq.com



通讯作者: 郑振国, 主任医师。E-mail: kzzg@sina.com 中图分类号: R541.4


摘要:目的探讨超敏C反应蛋白（high-sensitivity C-reactive protein，hs-CRP）和同型半胱氨酸（homocysteine，Hcy）对焦虑障碍患者合并冠心病的临床预测意义。方法选取2020年7月至2021年9月在大连大学附属中山医院心内科以胸痛、胸闷为主要表现且汉密尔顿焦虑量表（Hamilton Anxiety Scale，HAMA）评分>14分的住院患者198例。然后行冠脉造影（coronary angiography，CAG）检查，将患者分为焦虑障碍合并冠心病组74例与单纯焦虑障碍组124例。收集并比较两组患者临床数据，包括性别、年龄、高血压病史、糖尿病史、吸烟史、体质质量指数（body mass index，BMI）及hs-CRP、Hcy、纤维蛋白原、D-二聚体、皮质醇、血肌酐、低密度脂蛋白等的血清水平。采用t检验、Z检验、卡方分析、Spearman相关分析、二元logistic回归分析、受试者工作特征曲线（receiver operating characteristic curve，ROC曲线）等评估相关临床数据。结果焦虑障碍合并冠心病组血清hs-CRP、Hcy水平显著高于单纯焦虑障碍组（P < 0.05）。hs-CRP、Hcy与冠状动脉Gensini评分呈正相关（r=0.267，P < 0.01；r=0.285，P < 0.01）。多因素logistic回归分析得出hs-CRP是焦虑障碍患者合并冠心病的独立危险因素（P < 0.05）。ROC曲线结果表明hs-CRP、Hcy及两者联合检测对焦虑障碍患者合并冠心病有临床预测价值，并且两者联合检测的曲线下面积（AUC）显著高于任一单项指标（P < 0.05）。结论hs-CRP与Hcy血清水平联合检测对评估焦虑障碍患者是否合并冠心病有重要的临床预测价值。
关键词: 冠心病/
焦虑障碍/
超敏C反应蛋白/
同型半胱氨酸/
汉密尔顿焦虑量表


Abstract:ObjectiveTo investigate the clinical predictive value of high-sensitivity C-reactive protein (hs-CRP) and homocysteine (Hcy) on coronary heart disease (CHD) in patients with anxiety disorder.MethodsA total of 198 in patients with chest pain and chest tightness as the main manifestations and a Hamilton Anxiety Scale (HAMA) score > 14 were selected from July 2020 to September 2021 in the Department of Cardiology, Affiliated Zhongshan Hospital of Dalian University. The patients were divided into anxiety disorder with CHD group (observation group, n=74) and anxiety disorder without CHD group (control group, n=124), according to the coronary angiography (CAG) findings. Clinical data of the two groups were collected and compared, including gender, age, history of hypertension, history of diabetes, history of smoking, body mass index (BMI), and the serum levels of hs-CRP, Hcy, fibrinogen, D-dimer, cortisol, creatinine, and low-density lipoprotein cholesterol. T test, Z test, chi-square analysis, spearman rank correlation analysis, binary logistic regression analysis and receiver operating characteristic curve (ROC curve) were used to analyze the relevant clinical data.ResultsThe levels of hs-CRP and Hcy were significantly higher in the observation group than those in the control group (P < 0.05). hs-CRP and Hcy were positively correlated with coronary Gensini score (r=0.267, P < 0.01 and r=0.285, P < 0.01, respectively). Multivariate logistic regression analysis revealed that hs-CRP was an independent risk factor for CHD in patients with anxiety disorder (P < 0.05). ROC analysis demonstrated that hs-CRP, Hcy and their combination had clinical predictive value for CHD in patients with anxiety disorder, and the area under the curve (AUC) of the combined detection of the two factors was significantly higher than that of any single factor alone (P < 0.05).ConclusionThe combined detection of hs-CRP and Hcy levels has important clinical predictive value in evaluating whether patients with anxiety disorder are complicated with CHD.
Keywords:coronary heart disease/
anxiety disorder/
high-sensitivity C-reactive protein/
homocysteine/
hamilton anxiety scale

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