血清超敏C反应蛋白对冠状动脉粥样硬化性心脏病PCI手术患者危险分层与评估预后的价值  

Risk stratification and prognostic evaluation value of serum high sensitive C reactive protein in patients with coronary heart disease and PCI surgery

作　　者：沈正 刘兴德 韦波 李安敏 伍洪令 

机构地区：[1]贵州医科大学附属医院心内科,贵阳550004

出　　处：《重庆医学》2018年第1期54-56,共3页Chongqing medicine

摘　　要：目的探讨血清超敏C反应蛋白(hs-CRP)对冠状动脉粥样硬化性心脏病(简称冠心病)经皮冠状动脉介入治疗(PCI)手术患者危险分层与评估预后的价值。方法选取2013年3月至2015年9月该院收治的163例确诊为冠心病并且行PCI手术的患者,术前对所有患者均行冠状动脉造影检查,根据患者的hs-CRP水平将所有患者分为3组,运用Gemini评分对患者血管狭窄程度进行判断。完成手术后6个月内对患者进行随访,记录患者的主要心血管事件及分析患者hs-CRP水平和血管病变支数、Gemini评分以及不良心脏事件(MACE)和其他冠心病危险因素的关系。结果 3组患者在高血压和hs-CRP水平差异有统计学意义(P<0.05);术前hs-CRP水平和高敏肌钙蛋白T(hs-cTnT)水平呈现正相关关系(r=0.44,P<0.001),而hs-CRP水平和高密度脂蛋白胆固醇(HDL-C)则呈现负相关关系(r=-0.18,P=0.003);随着患者Gemini评分的升高患者hs-CRP水平也同样升高,Gemini评分为重度血管狭窄和中度、轻度血管狭窄患者的hs-CRP水平分别为(17.11±9.58)、(10.02±3.59)、(4.11±1.62)mg/L,3者差异具有统计学意义(F=37.21,P<0.05)。术后6个月内3组患者的MACE发生率分别为32.1%、52.9%和59.2%,比较差异具有统计学意义(χ~2=13.523,P=0.001),并且靶病变血运重建率的比较差异具有统计学意义(χ~2=7.522,P=0.022)。hs-CRP水平是患者出现MACE的独立危险因素(OR=2.06,95%CI:1.31~3.42,P=0.005)。结论血清hs-CRP是冠心病患者PCI术后出现心血管事件的独立危险因素。Objective To investigate the value of serum high sensitive C reactive protein（hs-CRP） in the risk stratification and prognosis evaluation in the patients with coronary heart disease and PCI operation. Methods One hundred and sixty-three cases of coronary heart disease and undergoing PCI in this hospital from March 2013 to September 2015 were selected and performed the coronary angiography examination before operation. Then the patients were divided into 3 groups according to the hs-CRP level. The Gensini score was used to judge the blood vessel stenosis degree. The patients were followed up within six months after surgery. The major cardiovascular events were recorded and the relationship between the hs-CRP level with the number of diseased vessels, Gensini score,MACE and other coronary heart disease risk factors was analyzed. Results Hypertension and hs-CRP level had sta- tistically significant difference among 3 groups（P〈-0.05） ;preoperative hs-CRP level showed positive correlation with hs-cTnT level （r=0.44, P〈0. 001）, while the hs-CRP was negatively correlated with the HDL-C level（r= - 0.18, P = 0.003） ; with the Gemini score elevation,the hs-CRP level was similarly elevated,the hs-CRP levels in the patients with severe, moderate and mild vascular stenosis evaluated by Gensini＇s score were（17.11±9.58）,（10.02±3.59）,（4. 11±1.62）mg/L respectively,the difference among them had statistical significance（F=37.21, P〈0.05）. Within postoperative six months, the MACE occurrence rates in 3 groups were 32.1%,52.9% and 59.2% respectively, the differences among the three groups were statistically significant（χ^2= 13.523, P= 0.001）, and the target lesion blood supply reconstruction rate had statistically significant difference（χ^2=7.522, P=0.022）. The hs-CRP level was an independent risk factor of MACE occurrence（OR= 2.06,95%CI：1.31-3.42,P=0.005）. Conclusion Serum hs-CRP is an independent risk factor for cardiovascular events occurrence after PCI surgery in the patie

关 键 词：冠心病 血管成形术 经腔 经皮冠状动脉 C反应性蛋白质 危险 预后 

分 类 号：R541.4[医药卫生—心血管疾病]