血清C反应蛋白水平与老年急性心肌梗死患者预后相关性分析  

Association between serum CRP level and outcome in elderly patients with acute myocardial infarction

作　　者：黄晖[1] 梁婷[1] 杨文娟[1] 丛广志[1] 杨生平[1] 张国山[1] 吴辉[1] 张丽萍[1] 贾绍斌[1] 

机构地区：[1]宁夏医科大学总医院心脏中心,银川750004

出　　处：《中华老年心脑血管病杂志》2016年第12期1255-1258,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

摘　　要：目的探求可预测急性心肌梗死患者长期生存率的有效实验室标记物。方法通过回顾性分析2014年2月-2015年6月在我院就诊的老年急性心肌梗死患者病历资料共615例，住院期阊发生不良事件患者43例（不良事件组），未发生不良事件患者572倒（无不良事件组），记录2组患者一般实验室指标和LVEF，随访1年生存情况，并进行统计学分析。结果不良事件组N末端B型钠尿肽前体、K＋、C反应蛋白水平明显高于无幂良事件组[（1673．17±340．87）ng／L vs（920．64±115．96）ng／L，P=0．040；（4．19±0．55）mmol／L vs（4．01±0．44）mmol／L，P=0．006；14．15mg／L讲8．81mg／L，P=0．022]。COX死亡回归模型分析显示，血清C反应蛋白水平升高是惠者预后不良的独立危险因素（OR=1．014，95％CI：I．009～1．020，P=0．000）。采用ROC曲线分析C反应蛋白对于急性心肌梗死死亡预测价值，曲线下面积为0．744，且C反应蛋白为52．05mg／L时，具有最佳预测效能，敏感性为52．38％，特异性为88．95％。采用Kaplan-Meier生存率分析，低c反应蛋白患者1年生存率明显高于高C反应蛋白患者（97．2％VS77．5％，P〈0．01）。结论血清C反应蛋白水平可预测急性心肌梗死患者的长期生存率。Objective To study the effective markers for predicting the long-term survival rate in patients with acute myocardial infarction （AMI）. Methods Six hundred and fifteen AMI patients admitted to our hospital from February 2014 to June 2015 were divided into adverse events group （n：43） and adverse events-free group （n=572）. The patients were followed up for 12 months, during which their general laboratory data and LVEF were recorded. Results The serum NT-proBNP,K＋ and CRP levels were significantly higher in adverse events group than in adverse events-free group （1673.17±340. 87 ng/L vs 92（L 64±115.96 ng/L, P = 0. 040; 4. 19±0. 55 mmol/L vs 4.01±0. 44 mmoL/L,P=0. 006;14.15 mg/L vs 8.81 mg/L,P=0. 022）. COX regression model analysis revealed that elevated serum CRP level was an independent risk factor for the poor ontcome in AMI patients （OR= 1. 014,95% CI：1. 009-1.020 ,P=0. 000）. The area under the ROC curve was 0. 744,which was a best predictor of the outcome in AMI patients when the serum CRP level was 52.05 mg/L with a sensitivity of 52.38% and a specificity of 88.95%. Kap-Inn-Meier survival rate analysis showed that the 1-year survival rate was significantly higher in patients with a low serum CRP level than in those with a high serum CRP level （97.2% vs 77. 5%,P〈0, 01）. Conclusion Serum CRP level can predict the long-term survival rate in AMI patients.

关 键 词：C反应蛋白质 心肌梗死 ROC曲线 危险因素 预后 

分 类 号：R542.22[医药卫生—心血管疾病]