血小板反应指数、血尿酸及半胱氨酸蛋白酶抑制剂C在非ST段抬高急性冠脉综合征患者中的表达及与病情、预后的相关性分析  

Expression of Platelet Reactive Index,Blood Uric Acid and Cystatin C in Patients with non-ST-segment Elevation Acute Coronary Syndrome and the Correlation with Severity and Prognosis

作　　者：张卢燕 田雅玲[1] 韩孝宇[4] 王秀琴[1] 朱爱红[4] 任红[2] 董丽[3] 程宝月 ZHANG Lu-yan;TIAN Ya-ling;HAN Xiao-yu;WANG Xiu-qin;ZHU Ai-hong;REN Hong;DONG Li;CHENG Bao-yue(Return Visit Center,First Hospital of Qinhuangdao,Qinhuangdao 066000,Hebei,China;Performance Management Department,First Hospital of Qinhuangdao,Qinhuangdao 066000,Hebei,China;Geriatrics Department,First Hospital of Qinhuangdao,Qinhuangdao 066000,Hebei,China;CCU,First Hospital of Qinhuangdao,Qinhuangdao 066000,Hebei,China;Public Health Administration,First Hospital of Qinhuangdao,Qinhuangdao 066000,Hebei,China)

机构地区：[1]秦皇岛市第一医院回访中心,秦皇岛市066000 [2]秦皇岛市第一医院绩效管理科,秦皇岛市066000 [3]秦皇岛市第一医院老年病科,秦皇岛市066000 [4]秦皇岛市第一医院CCU,秦皇岛市066000 [5]秦皇岛市第一医院公共卫生管理处,秦皇岛市066000

出　　处：《中国分子心脏病学杂志》2021年第4期4096-4099,共4页Molecular Cardiology of China

基　　金：秦皇岛市科学技术研究与发展计划(202004A037)。

摘　　要：目的分析血小板反应指数(platelet reactive index,PRI)、血尿酸及半胱氨酸蛋白酶抑制剂C(cystatin C,Cys C)在非ST段抬高急性冠脉综合征(non-ST-segment elevation acute coronary syndrome,NSTE-ACS)患者中的表达及与病情、预后的相关性。方法选取2018年2月至2019年12月于秦皇岛市第一医院就诊的110例NSTE-ACS患者纳入研究组,计算患者GRACE评分并根据评分情况进行分组:低危组(n=51)、中危组(n=35)和高危组(n=24)。选取同期100例进行健康体检者作为对照组。比较各组间PRI、血尿酸及Cys C的表达情况;记录NSTE-ACS患者预后情况,采用多元Logistic回归分析影响NSTE-ACS患者预后不良的危险因素,采用ROC曲线分析PRI、血尿酸及Cys C对患者预后不良的影响。结果研究组PRI、血尿酸及Cys C水平明显高于对照组(P<0.05);研究组三组PRI、血尿酸及Cys C水平比较,低危组<中危组<高危组(P<0.05);截至随访结束,110例NSTE-ACS患者中29例(26.36%)出现心血管不良事件。PRI、血尿酸及Cys C异常升高是影响NSTE-ACS患者预后不良危险因素(r=2.565,P<0.001;r=2.491,P<0.001;r=2.496,P<0.001)。ROC显示:PRI、血尿酸、Cys C及三者联合曲线下面积分别为0.702、0.810、0.646、0.915,各指标曲线下面积以联合检测最大。结论PRI、血尿酸、Cys C水平在NSTE-ACS患者中显著升高,联合三者检测可作为评估患者预后不良的有效手段,临床上应检测其水平并及时进行干预,进而改善预后。Objective To analyze the expression of platelet reactive index(PRI),blood uric acid and cystatin C(Cys C)in patients with non-ST-segment elevation acute coronary syndrome(NSTE-ACS)and its correlation with severity and prognosis.Methods 110 NSTE-ACS patients treated in the First Hospital of Qinhuangdao from February 2018 to December 2019 were selected,and the GRACS scores of the patients were calculated.According to the scores,the patients were divided into three groups:low-risk group(n=51),intermediate-risk group(n=35),and high-risk group(n=24).100 patients who had physical examination in the First Hospital of Qinhuangdao during the same period were selected as the control group.The expressions of PRI,blood uric acid and Cys C between the groups were compared.The prognosis of patients with NSTE-ACS was recorded.Multivariate Logistic regression was used to analyze the risk factors affecting the poor prognosis of NSTE-ACS patients,and ROC curve analysis was used to study the effects of PRI,blood uric acid and Cys C on the poor prognosis of patients.Results The levels of PRI,blood uric acid and Cys C in the study group were significantly higher than those in the control group(P<0.05).The levels of PRI,blood uric acid and Cys C in the three groups of the study group were as follows:low-risk group<intermediate-risk group<high-risk group(P<0.05).As of the end of follow-up,29(26.36%)of 110 NSTE-ACS patients had major adverse cardiovascular events(MACE).The abnormal increasing of PRI,blood uric acid and Cys C were risk factors that affected the prognosis of patients with NSTE-ACS(r=2.565,P<0.001;r=2.491,P<0.001;r=2.496,P<0.001).ROC showed that the areas under the PRI,blood uric acid and Cys C curves and the combined curve of them were 0.702,0.810,0.646,0.915,respectively,and the area under the combined curve was the largest.Conclusion The levels of PRI,blood uric acid,and Cys C significantly increased in NSTE-ACS patients.The combined detection of the them can be used as an effective means to assess the poor prognosis of

关 键 词：血小板反应指数 血尿酸 半胱氨酸蛋白酶抑制剂C 非ST段抬高急性冠脉综合征 

分 类 号：R541.4[医药卫生—心血管疾病]