冠心病患者PCI术前后cTn-T、sCD40L、hs-CR与预后的相关性  

Correlation between cTn-T,sCD40L,hs-CR and prognosis in patients with coronary heart disease before and after PCI

作　　者：张静静 刘彦铭 ZHANG Jingjing;LIU Yanming(Department of Cardiovasular Medicine,Second People s Hospital of Pingdingshan,Pingdingshan Henan 467000,China)

机构地区：[1]平顶山市第二人民医院心血管内科,河南平顶山467000

出　　处：《云南医药》2024年第5期48-51,共4页Medicine and Pharmacy of Yunnan

摘　　要：目的分析冠心病患者PCI前后cTn-T、sCD40L、hs-CRP水平与预后的相关性。方法将本院行PCI术的192例患者根据术后12个月是否发生并发症及不良心脏事件分为预后良好组(n=156)和预后不良组(n=36),比较2组cTn-T、sCD40L、hs-CRP水平。建立ROC曲线分析血清cTn-T、sCD40L、hs-CRP水平对CAD的预测价值。结果2组术后24 h cTn-T、sCD40L、hs-CRP水平均高于术前、术后10 min,差异有统计学意义(P<0.05)。术后24 h预后不良组cTn-T、sCD40L、hs-CRP水平均高于预后良好组,差异有统计学意义(P<0.05)。cTn-T、sCD40L、hs-CRP预测PCI术后并发症及MACE的最佳截断值为0.36 mg/L、4.11mg/mL、8.28mg/mL,敏感度分别为55.26%、73.29%、81.28%,特异度分别为76.29%、51.42%、69.37%。三个指标联合检测的敏感度和特异度分别为84.29%、78.33%,高于单一指标。结论PCI可在一定程度上激活CAD患者血管局部及全身的炎症反应,导致心肌损伤,引发并发症及MACE。cTn-T、sCD40L、hs-CRP可作为评价CAD患者PCI预后的辅助指标。Objective To analyze the correlation between the levels of cTn-T,sCD40L,hs-CRP and prognosis in patients with coronary heart disease before and after PCI.Methods 192 patients who underwent PCI in our hospital were divided into good prognosis group(n=156)and poor prognosis group(n=36)according to whether complications and adverse cardiac events occurred 12 months after the operation.The cTn-T,sCD40L,and hs-CRPcTn level of the two groups were compared.ROC curve was established to analyze the predictive value of serum cTn-T,sCD40L and hs-CRP level for CAD.Results The levels of cTn-T,sCD40L and hs-CRP at 24 hours after operation in the two groups were higher than those before operation and 10 minutes after operation,and the difference was statistically significant(P<0.05).The levels of cTn-T,sCD40L and hs-CRP in the poor prognosis group at 24 hours after operation were higher than those in the good prognosis group,and the difference was statistically significant(P<0.05).The optimal cut-off values of cTn-T,sCD40L and hs-CRP for predicting postoperative complications and MACE after PCI were 0.36 mg/L,4.11 mg/mL and 8.28 mg/mL,with sensitivities of 55.26%,73.29%and 81.28%,respectively,the specificities was 76.29%,51.42%and 69.37%,respectively.The sensitivity and specificity of the combined detection of the three indicators was 84.29%and 78.33%,respectively,which were higher than those of a single indicator.Conclusions PCI can activate the local and systemic inflammatory response of the blood vessels in CAD patients to a certain extent,leading to myocardial injury,complications and MACE.cTn-T,sCD40L and hs-CRP can be used as auxiliary indicators to evaluate the prognosis of CAD patients with PCI.

关 键 词：冠心病 经皮冠状动脉介入术 肌钙蛋白-T 可溶性CD40L 超敏C反应蛋白 

分 类 号：R541.4[医药卫生—心血管疾病]