老年STEMI患者冠状动脉病变与血清CRP、Hcy及血浆Fig水平的关系研究  

Relationship between coronary arterial lesion with serum CRP,Hcy and plasma Fig levels in elderly patients with STEMI

作　　者：梅长波 田晓慧 MEI Changbo;TIAN Xiaohui(Department of Emergency,Xianyang Municipal First People's Hospital,Xianyang,Shaanxi 712000,China;Department of Cadres Health Care,Xianyang Municipal First People's Hospital,Xianyang,Shaanxi 712000,China)

机构地区：[1]陕西省咸阳市第一人民医院急诊科,陕西咸阳712000 [2]陕西省咸阳市第一人民医院干部保健病区,陕西咸阳712000

出　　处：《检验医学与临床》2023年第19期2855-2858,共4页Laboratory Medicine and Clinic

摘　　要：目的研究老年ST段抬高型心肌梗死(STEMI)患者冠状动脉病变与血清C反应蛋白(CRP)、同型半胱氨酸(Hcy)及血浆纤维蛋白原(Fig)水平的关系。方法选择2020年1月至2022年1月204例老年STEMI患者为研究对象,均行冠状动脉造影检查,根据冠状动脉病变情况分为单支病变组(118例)、多支病变组(86例)。收集患者的一般资料,进行血常规和血脂检测,检测血清CRP、Hcy及血浆Fig水平;以受试者工作特征(ROC)曲线分析CRP、Hcy、Fig预测老年STEMI患者冠状动脉多支病变的价值,采取非条件Logistic回归分析老年STEMI患者冠状动脉多支病变的危险因素;采用Spearman相关分析CRP、Hcy及Fig水平与冠状动脉病变支数的相关性。结果经ROC曲线分析,CRP为8.272 mg/L、Fig为4.722 g/L、Hcy为21.094 mg/L是老年STEMI患者冠状动脉多支病变的最佳截断值(P<0.05);Logistic回归分析显示,高血压(OR=2.258,95%CI:1.639~3.111)、TIMI分级<3级(OR=3.775,95%CI:3.204~4.448)、Killip分级Ⅲ级(OR=3.102,95%CI:2.125~4.528)、CRP≥8.215 mg/L(OR=1.639,95%CI:1.223~2.197)、Fig≥4.643 g/L(OR=2.206,95%CI:1.215~4.005)、Hcy≥20.564 mg/L(OR=2.561,95%CI:1.247~5.260)是老年STEMI患者冠状动脉多支病变的危险因素(P<0.05);经相关性分析,CRP、Hcy、Fig水平与老年STEMI患者冠状动脉病变支数呈正相关(r=0.526、0.609、0.574,P<0.05)。结论老年STEMI患者冠状动脉病变支数与血清CRP、Hcy及血浆Fig水平呈正相关,临床可通过检测以上指标对冠状动脉多支病变患者进行筛查。Objective To investigate the relationship between coronary arterial lesion with serum C-reactive protein(CRP),homocysteine(Hcy)and plasma fibrinogen(Fig)levels in elderly patients with ST-segment elevation myocardial infarction(STEMI).Methods A total of 204 elderly patients with STEMI from January 2020 to January 2022 were selected as the study subjects,conducted the coronary angiography examination and were divided into the single-vessel lesion group(118 cases)and multi-vessel lesions group(86 cases)according to their coronary arterial lesions.The general data of the patients were collected,blood routine and lipid detection were performed,and serum CRP,Hcy and plasma Fig levels were determined.The receiver operating characteristic(ROC)curve was used to analyze the value of CRP,Hcy and Fig in predicting multi-vessel coronary arterial lesions in senile STEMI patients,and the unconditional Logistic regression was used to analyze the risk factors of multi-vessel coronary arterial lesion in senile STEMI patients.The correlation between CRP,Hcy and Fig with the number of coronary arterial lesions was analyzed by the Spearman correlation.Results According to the ROC curve analysis,CRP=8.272 mg/L,Fig=4.722 g/L and Hcy=21.094 mg/L were the best cut-off values of coronary artery multi-vessel lesions in elderly STEMI patients(P<0.05).The Logistic regression analysis showed that hypertension(OR=2.258,95%CI:1.639 to 3.111),TIMI grade<3(OR=3.775,95%CI:3.204 to 4.448),Killip grade Ⅲ(OR=3.102,95%CI:2.125 to 4.528),CRP≥8.215 mg/L(OR=1.639,95%CI:1.223 to 2.197),Fig≥4.643 g/L(OR=2.206,95%CI:1.215 to 4.005),Hcy≥20.564 mg/L(OR=2.561,95%CI:1.247 to 5.260)were the risk factors for coronary artery multi-vessel lesions in elderly patients with STEMI(P<0.05).The correlation analysis showed that CRP,Hcy and Fig levels were positively correlated with the number of coronary artery lesions in senile STEMI patients(r=0.526,0.609,0.574,P<0.05).Conclusion The number of coronary artery lesions in senile STEMI patients is positively corre

关 键 词：ST段抬高型心肌梗死 冠状动脉病变 C反应蛋白 纤维蛋白原 同型半胱氨酸 老年 

分 类 号：R541.4[医药卫生—心血管疾病]