胰岛素抵抗指数及高敏C-反应蛋白对急性冠脉综合征冠脉病变的预测价值

The predictive value of insulin resistance index and hsCRP in acute coronary syndrome

目的探讨胰岛素抵抗指数(insulin resistance index,IRI)及血清高敏C-反应蛋白(hsCRP)在急性冠脉综合征(ACS)病情及预后方面的预测价值。方法选择ACS患者171例及32例正常健康人作为对照组,分别测定各组身高、体重、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDLc)、低密度脂蛋白胆固醇(LDLc)水平、空腹血糖(FPG)、空腹胰岛素(Fins)水平及冠脉狭窄程度,计算体重指数(BMI)、稳态模型评估法(HOMA)评估IRI(HOMA-IR)、冠脉阻塞积分(CAOS)并进行对比分析。结果 ACS患者TC、LDLc、FPG、Fins、HOMA-IR、hsCRP、CAOS积分均显著高于正常对照组,HDLc水平明显低于对照组(P<0.05)。结论 ACS患者存在明显胰岛素抵抗;IRI及hsCRP水平对不同病情ACS具有较高的预测价值;IRI及hsCRP水平在ACS病情的诊疗及预后的判断中可以作为一个很好的预测指标。

Objective To investigate the predictive value of insulin resistance index(IRI) and high sensitivity C-reactive protein(hsCRP) in acute coronary syndrome(ACS) and its prognosis.Methods Totally 171 patients with ACS were recruited as ACS group and 32 healthy subjects served as control group.We detected body height,body mass,blood lipids(including TG,HDLc,TC and LDLc),free plasma glucose,fasting insulin and the severity of coronary artery lesion,calculated body mass index(BMI),HOMA-IR and coronary artery obstacle score(CAOS score),and then compared them.Results The levels of TC,LDLc,FPG,Fins,HOMA-IR,hsCRP,and CAOS score in ACS group were much higher than those in control group,while the level of HDLc was much lower than that in control group(P<0.05).Conclusion Insulin resistance exists in ACS patients.Insulin resistance index and high sensitivity C-reactive protein play an important role in the development of ACS,and their levels are highly predictive in ACS.Insulin resistance index together with high sensitivity C-reactive protein could be a very important marker to predict ACS.