术前CRP水平与冠状动脉旁路移植术患者预后的关系

Relationship between preoperative CRP level and prognosis of patients undergoing coronary artery bypass grafting

目的探讨术前C反应蛋白(C-reactive protein,CRP)水平对冠状动脉旁路移植术(Coronary artery bypass grafting,CABG)后早期和晚期死亡率的预测价值。方法采用前瞻性研究分析2011年1月—2018年12月山西省心血管病医院收治的1800例行CABG术的冠心病患者的临床资料及术前24 h内血清CRP水平,并分析术前CRP水平与CABG术后早期和晚期死亡率的关系。随访过程中有106例患者失访。结果发现术前CRP水平大于10 mg/L时早期死亡率增加,而大于5 mg/L时晚期死亡率增加,并且经过多因素COX比例风险模型校正多项已知危险因素后,术前CRP水平仍是CABG术后早期及晚期死亡的独立危险因素。结论术前CRP水平是CABG术后危险分层的强有力的炎症指标,对于CABG术后预后的评价具有重要指导意义。

Objective To analyze the predictive value of preoperative C-reactive protein(CRP)levels for early and late mortality in paitents with coronary artery bypass grafting(CABG).Methods From January 2011 to December 2018,1800 patients with coronary heart disease who underwent CABG surgery in Shanxi Cardiovascular Hospital were continuously selected,and their clinical data and serum CRP levels within 24 hours before surgery were collected.The relationship between early and long-term mortality of CRP levels were analyzed.Results Totally106 patients were unavailable for follow-up.The results showed that early mortality increased when preoperative CRP level was greater than 10 mg/L,and late mortality increased when preoperative CRP level was greater than 5 mg/L.After multiple risk factors were corrected by multivariate COX proportional hazard models,preoperative CRP level was still an independent risk factor for early and late death after CABG.Conclusion Preoperative CRP level can be used as a powerful inflammatory marker for risk stratification after CABG,and it is an important guiding factor for the evaluation of prognosis after CABG.