简介：目的通过分析不同冠状动脉（冠脉）狭窄程度患者冠脉Gensini积分及血浆脂蛋白a[lipoprotein（a）,Lp（a）]的相关性,了解Lp（a）与冠脉病变程度的关系。方法将180例非急性冠脉综合征择期行冠脉造影的患者,根据冠脉造影结果分成非冠状动脉粥样硬化性心脏病（冠心病）组（对照组）,单支病变组,二支病变组,三支和（或）主干病变组。多组间两两血浆Lp（a）浓度及Gensini积分比较采用LSD-t检验进行分析;Lp（a）与Gensini积分的相关性分析选用spearman秩相关进行分析。结果4组间Lp（a）浓度比较,差异无统计学意义（P〉0.05）,仅三支组和（或）主干病变组Lp（a）浓度与Gensini积分有弱相关性（Sr=0.281,P=0.042）。结论在严重冠脉病变患者中Lp（a）浓度与冠脉病变程度呈正相关关系。

简介：摘要目的讨论超敏C反应蛋白（hs-CRP）与冠心病及其严重程度间的关系。方法选择2012年1月至2013年5月在心内科住院的疑似冠心病患者67例，其中男性48例，女性19例。所有患者均通过化学发光法测定hs-CRP，所有患者均行冠状动脉造影，并计算Gensini评分，进一步比较各组间hs-CRP。结果hs-CRP在稳定性心绞痛、不稳定性心绞痛、非ST段抬高型心肌梗死及ST段抬高型心肌梗死患者中的差异有统计学意义（P=0.001）。hs-CRP在冠状动脉无狭窄组、轻度狭窄组、中度狭窄组及重度狭窄组间的差异有统计学意义（P=0.001），但hs-CRP与冠状动脉植入支架的个数无关，hs-CRP与Gensini评分相关。结论hs-CRP与Gensini评分及冠心病的严重程度相关，是可以预测冠心病的严重程度的辅助指标。

简介：摘要目的探讨肥胖冠心病患者中非酒精性脂肪肝（NAFLD）与Gensini评分之间的关系。方法回顾性分析广东省化州市人民医院心血管内科于2016年1月至2019年12月行冠状动脉造影检查的超重或肥胖患者共367例，记录所有患者的的一般资料、生化指标、入院时的危险程度GRACE（the global registry of acute coronary events）评分及冠脉造影的Gensini评分，记录NAFLD超声和CT的评估结果。结果NAFLD组的UA和TG水平显著高于非NAFLD组，而HDL-C则显著低于非NAFLD组（P<0.001）；NAFLD组的Gensini评分显著高于非NAFLD组（t=6.504，P<0.001)，重度NAFLD患者的Gensini评分显著高于轻度和中度组（P<0.05）；肥胖冠心病患者合并NAFLD（OR：1.64，95%CI：1.17-1.95，P=0.002）是高Gensini评分的风险因素。结论肥胖冠心病患者中非酒精性脂肪肝的严重程度与Gensini评分呈正相关，非酒精性脂肪肝是冠脉严重病变的独立风险因素。

简介：AbstractBackground:The platelet to lymphocyte ratio (PLR) has recently emerged as a potential inflammatory biomarker and has been shown to be significantly associated with atherosclerotic coronary artery disease (CAD). Therefore, we aimed to explore the association of PLR with in-hospital major adverse cardiovascular events (MACEs) and the severity of CAD assessed by the Gensini score (GS) in patients with acute myocardial infarction (AMI) undergoing coronary angiography.Methods:A total of 502 patients with AMI consecutively treated at the Affiliated Hospital of Qingdao University (Qingdao, China) and underwent coronary angiography from August 2017 to December 2018 were recruited in this study. The demographic, clinical, angiographic characteristics, and laboratory parameters were collected. According to the presence of in-hospital MACEs, the included patients were divided into the MACE group (n = 81) and the non-MACE group (n = 421). Further, according to tertiles of the GS, the patients were classified into three groups: the low GS group (GS ≤32 points, n = 173), medium GS group (32 points < GS ≤ 60 points, n = 169), and high GS group (60 points < GS ≤ 180 points, n = 160). The main statistical methods included Chisquared test, non-parametric Mann-Whitney U test, Kruskal-Wallis H test, logistic regression, and receiver operating characteristic curves.Results:The PLR in the MACE group was significantly higher than that in the non-MACE group (179.43 [132.84, 239.74] vs. 116.11 [87.98, 145.45], Z = -8.109, P < 0.001). Further, there were significant differences in PLR among the tertiles of GS (110.05[84.57, 139.06] vs. 119.78 [98.44, 157.98] vs. 140.00 [102.27, 191.83], H= 19.524, P < 0.001). PLR was demonstrated to be an independent risk factor of in-hospital MACEs (odds ratio [OR]: 1.012, 95% confidential interval [CI]: 1.006-1.018, P < 0.001) and severe CAD assessed by the GS (OR: 1.004, 95% CI: 1.002-1.009, P= 0.042). The cutoff value of PLR for predicting the development of in-hospital MACEs was 151.28 with a sensitivity of 66.7% and a specificity of 78.1% (area under the curve [AUC]: 0.786, 95% CI: 0.730-0.842, P < 0.001), and a PLR of 139.31 was also identified to be an effective cutoff point for detecting a high GS (<60 points) with a sensitivity of 49.4% and a specificity of 69.6% (AUC: 0.611, 95% CI: 0.556-0.666, P < 0.001).Conclusions:PLR as a novel inflammatory marker is significantly and independently associated with the occurrence of in-hospital MACEs and the severity of CAD assessed by the GS in patients with AMI. As an easily available and inexpensive inflammatory indicator, PLR could be widely used as an efficient inflammatory biomarker for identifying high-risk patients and for individualizing targeted therapy to improve the prognosis of AMI.

简介：摘要目的探讨人不对称性二甲基精氨酸（ADMA)与冠心病Gensini积分的相关性。方法选取55例患者，均行冠脉造影检查，然后按Gensini积分结果，将55例患者分为3组，积分＜20组(27例），20≤积分＜40组（12例），积分≥40组（16例），测定各组血清中ADMA浓度，进行对比，分析ADMA水平与冠心病Gensini积分的相关关系。结果三组患者血清中ADMA浓度比较无统计学意义（P>0.05）。结论外周血中ADMA水平与冠心病Gensini积分无明显相关关系，提示外周血中ADMA与冠心病冠脉病变严重程度无关。

简介：摘要目的探讨冠心病合并糖尿病患者糖化血红蛋白(HbA1c)水平与冠状动脉Gensini评分的关系。方法对2011-3.1-2012-3.1在我院住院由冠状动脉造影确诊为冠心病的糖尿病患者123例测定其HbA1c值，根据HbA1c值，分为血糖控制良好组（HbA1c<6.5%）共40例、血糖控制不良组（HbA1c≥6.5%）共83例；并通过Gensini评分系统对其冠状动脉进行评分。结果血糖控制良好组患者Gensini评分显著大于血糖控制不佳组；Gensini评分与糖化血红蛋白呈正相关。结论糖化血红蛋白可以作为预测冠状动脉病变严重程度指标之一。

简介：目的：探讨急性冠状动脉综合征（ACS）患者冠状动脉Gensini评分与血清超敏C反应蛋白（hsCRP）水平的相关性。方法：回顾性分析2013-08-2014-08我院内科治疗的135例ACS患者临床资料,依据Gensini评分判定冠状动脉病变的严重程度,并将其分为3组,重度病变组46例,中度病变组45例,轻度病变组44例,另选择冠状动脉造影（CAG）无明显异常者45例作为对照组,观察4组冠状动脉狭窄程度,并对比4组Gensini评分,以Logistic回归模型、Spearman相关性分析判定各危险因素与Gensini评分的关系。结果：与对照组比较,ACS各组血清hs-CRP水平均明显升高,差异有统计学意义（P〈0.05）,以Gensini评分为因变量,以年龄、SBP、hs-CRP、低密度脂蛋白（LDL-C）、空腹血糖（FPG）为自变量,实施多元Logistic回归分析,提示年龄、SBP、hs-CRP、LDL-C、FPG是冠状病变狭窄程度的独立危险因素。实施Spearman相关性分析,将Gensini评分作为变量,判定Gensini评分与hs-CRP水平的相关性,提示hs-CRP水平与Gensini评分呈正相关（P〈0.01,r=0.915）。结论：ACS患者通过检测血清hs-CRP水平,能够对冠状动脉狭窄程度进行预测,方便快速,可以为临床提供诊断依据。