血清高敏C反应蛋白/前白蛋白比值与急性ST段抬高型心肌梗死患者PCI术后冠状动脉无复流的相关性  

Correlation between serum high-sensitivity C-reactive protein/prealbumin ratio and coronary no-reflow after PCI in patients with acute ST-segment elevation myocardial infarction

作　　者：李相权 于宗良 张梦遥 王俊锋 王腾 陶宁超 张梓桑 LI Xiang-quan;YU Zong-liang;ZHANG Meng-yao;WANG Jun-feng;WANG Teng;TAO Ning-chao;ZHANG Zi-sang(Department of Cardiology,the First People s Hospital of Kunshan,Suzhou 215300,Jiangsu,China)

机构地区：[1]昆山市第一人民医院心血管内科,江苏苏州215300

出　　处：《川北医学院学报》2024年第7期888-891,共4页Journal of North Sichuan Medical College

基　　金：国家自然科学基金项目(81700737)。

摘　　要：目的:探讨高敏C反应蛋白/前白蛋白(hs-CRP/PA)比值对急性ST段抬高型心肌梗死(STEMI)患者PCI术后冠状动脉无复流的预测价值。方法:选取98例急性STEMI患者作为研究对象,按术后心肌梗死溶栓试验(TIMI)血流分级将患者分为无复流组(n=25)与复流组(n=73)。PCI术前,检测患者血清hs-CRP、PA水平,并计算hs-CRP/PA比值。采用Logistic回归模型分析PCI术后冠状动脉无复流的影响因素,采用受试者工作特征(ROC)曲线评价hs-CRP/PA比值对冠状动脉无复流的预测价值。结果:相比于复流组,无复流组术前LVEF、cTnI、BNP、hs-CRP及hs-CRP/PA比值更高(P<0.05),发病至再灌注时间更长(P<0.05),血清PA水平更低(P<0.05)。Logistic回归分析表明,术前LVEF、hs-CRP、PA及hs-CRP/PA比值均是PCI术后冠脉无复流的独立相关因素(P<0.05)。ROC曲线分析显示,hs-CRP/PA比值预测急性STEMI患者PCI术后冠状动脉无复流的AUC为0.802,高于hs-CRP的0.707和PA的0.642(P<0.05);当截断值>28.5时,hs-CRP/PA比值预测的敏感度为88.0%,特异度为68.5%。结论:术前血清hs-CRP/PA比值是急性STEMI患者术后冠状动脉无复流的独立预测因子,相比于单一指标可较好识别冠状动脉无复流高危患者。Objective:To investigate the predictive value of high-sensitivity C-reactive protein/prealbumin(hs-CRP/PA)ratio for coronary no-reflow after PCI in patients with acute ST-segment elevation myocardial infarction(STEMI).Methods:A total of 98 patients with acute STEMI were selected.The patients were divided into no-reflow group(n=25)and reflow group(n=73)according to the postoperative thrombolysis in myocardial infarction(TIMI)blood flow classification.Before PCI,the levels of serum hs-CRP and PA were detected,and the ratio of hs-CRP/PA was calculated.Logistic regression model was used to analyze the influencing factors of coronary no-reflow after PCI,and the receiver operating characteristic(ROC)curve was used to evaluate the predictive efficacy of hs-CRP/PA ratio on coronary no-reflow.Results:Compared with the reflow group,the serum PA level in the no-reflow group was lower(P<0.05),and the LVEF,cTnI,BNP,hs-CRP and hs-CRP/PA ratio were higher(P<0.05).Logistic regression analysis showed that preoperative LVEF,hs-CRP,PA and hs-CRP/PA ratio were independent related factors of coronary no-reflow after PCI(P<0.05).ROC curve analysis showed that the AUC of hs-CRP/PA ratio in predicting coronary no-reflow after PCI in patients with acute STEMI was 0.802,which was higher than that of hs-CRP(AUC was 0.707)and PA(AUC was 0.642,P<0.05).When the cutoff value was greater than 28.5,the sensitivity of hs-CRP/PA ratio was 88.0%and the specificity was 68.5%.Conclusion:Preoperative serum hs-CRP/PA ratio is an independent predictor of postoperative coronary no-reflow in patients with acute STEMI.Compared with a single indicator,it can better identify patients with high risk of coronary no-reflow.

关 键 词：急性ST段抬高型心肌梗死 高敏C反应蛋白 前白蛋白 经皮冠状动脉介入治疗 无复流 

分 类 号：R714.252[医药卫生—妇产科学]