基线hs-CRP和LDL-C水平与不同急性冠状动脉综合征急性期预后的相关性及意义  

Correlation and significance of baseline hs-CRP and LDL-C levels with acute coronary syndrome prognosis

作　　者：曹春辉[1] 黄军[2] 王仲华[1] 方永祥[1] 张晓红[1] 

机构地区：[1]郴州市第一人民医院心内科,湖南郴州423000 [2]郴州市第一人民医院肝胆外科

出　　处：《现代预防医学》2012年第14期3741-3743,共3页Modern Preventive Medicine

摘　　要：目的探讨基线高敏C-反应蛋白(hs-CRP)和低密度脂蛋白胆固醇(LDL-C)水平与急性冠状动脉综合征(ACS)急性期预后的相关性及意义。方法选取某院98例冠状动脉综合征患者,所有患者入院24 h内测定基线状态的hs-CRP和LDL-C水平,治疗30 d后,按出现死亡、事件和无事件将患者分成3组,将3组患者基线hs-CRP和LDL-C水平进行比较分析,并对死亡组和事件组包括性别、年龄、hs-CRP、LDL-C在内的多项危险因素进行多因素Logistic回归分析,判断各因素对死亡率和事件发生率的影响。结果治疗30 d后,死亡组的基线hs-CRP水平(61.3±35.1)显著高于事件组(35.2±17.3)和无事件组(11.9±5.2),P﹤0.05;死亡组的基线LDL-C水平(3.5±1.2)与事件组(3.4±2.1)和无事件组(3.1±1.8),差异无统计学意义,P﹥0.05;Logistic回归分析发现,基线hs-CRP水平(OR=3.126)、ST异常抬高(OR=2.831)、LVEF(OR=2.143)、Cr水平(OR=2.809)、糖尿病(OR=3.219)等是影响死亡的危险因素,P﹤0.05;高血压(OR=2.723)、中风史(OR=2.185)、吸烟(OR=2.139)、基线hs-CRP水平(OR=2.536)、ST异常抬高(OR=2.941)、LVEF(OR=2.735)、Cr水平(OR=3.023)是影响血管事件的危险因素,P﹤0.05;事件组和无事件组的hs-CRP水平较治疗前均显著降低,P﹤0.05;两组LDL-C水平治疗后较治疗前均略有降低,差异无统计学意义,P﹥0.05。结论 ACS患者急性期死亡和事件与hs-CRP水平明显相关,但与基线LDL-C水平无关。治疗后Hs-CRP水平明显降低,可作为急性期治疗的靶目标。OBJECTIVE To investigate the correlation and significance for baseline high-sensitivity C-reactive protein（hs-CRP）and low-density lipoprotein cholesterol（LDL-C）levels in the prognosis of patients with acute coronary syndrome（ACS）.METHODS 98 cases of coronary syndrome patients in our hospital were chosen.The level of baseline hs-CRP and LDL-C of all patients in our hospital within 24 hours was measured.The determination of death events and event-free patients were divided into three groups after treatment for 30 days.The baseline hs-CRP and LDL-C levels of the three groups were compared.The risk factors of mortality and incidence were analyzed,including gender,age,hs-CRP and LDL-C.RESULTS After 30 days’ treatment,the death group baseline hs-CRP levels（61.3 ± 35.1）was significantly higher than the event group（35.2 ± 17.3）and event-free group（11.9 ± 5.2）（P﹤0.05）.The LDL-C level did not show significant difference among the death group（3.5 ± 1.2）,event group（3.4 ± 2.1）and non-event group（3.1 ± 1.8）（P﹥0.05）.Logistic regression analysis showed that the risk factors for the death were baseline of hs-CRP level（OR = 3.126）,the ST abnormalities elevation（OR = 2.831）and LVEF（OR = 2.143）,Cr level（OR = 2.809）and diabetes（OR = 3.219）（P﹤0.05）.The hypertension（OR = 2.723）,stroke history（OR = 2.185）,smoking（OR = 2.139）,hs-CRP levels（OR = 2.536）,abnormal elevation of the ST（OR = 2.941）and LVEF（OR = 2.735）,Cr level（OR = 3.023）were the risk factors for vascular events（P﹤0.05）.The hs-CRP levels for the event group and event-free group were significantly lower than those before treatment（P﹤0.05）.The LDL-C levels of the two groups were slightly lower than those before treatment,and no significant difference was found between them（P﹥0.05）.CONCLUSION The ACS patients with acute death and events,and hs-CRP levels were significantly correlated with baseline LDL-C levels.Hs-CRP levels were significantly lower after

关 键 词：冠状动脉疾病 急性期预后 HS-CRP LDL-C 

分 类 号：R543.3[医药卫生—心血管疾病]