血清hs-CRP检测对冠心病PCI手术患者病情及预后评估的价值

The significance of serum hs-CRP detection in the condition and prognosis assessment of PCI surgery patients with coronary heart disease

目的探讨血清超敏C反应蛋白（hs-CRP）与冠心病PCI手术患者的危险分层、冠状动脉病变严重程度和预后的关系。方法选取150例行PCI的冠心病患者,术前行冠状动脉造影并测定hs-CRP、TG、LDL-C、HDL-C、B型脑钠肽前体（NTproBNP）、超敏肌钙蛋白T（hs-cTnT）水平,根据hs-CRP水平将患者分为3组,采用Gemini评分判断血管狭窄程度。术后随访6个月,记录主要心血管事件,分析hs-CRP与其他冠心病危险因素、Gemini评分、血管病变支数、MACE的关系。结果 hs-CRP与HDL-C、hs-cTnT相关（r分别为-0.17、0.42,P〈0.05）。冠心病PCI手术患者患者血清hs-CRP浓度随着Gensini积分的增加而升高,重度血管病变患者的血清hs-CRP浓度明显高于轻度血管病变患者和中度血管病变患者（P〈0.05）。单支、双支和多支病变患者的hs-CRP水平分别为（4.64±5.39）、（9.86±8.75）、（14.93±10.34）mg/L,差异有统计学意义（F=13.67,P〈0.05）。hsCRP与Gemini评分、动脉血管病变数目的相关系数分别为0.21（P〈0.05）、0.18（P〈0.05）。三组不同hs-CRP水平的患者MACE发生率比较,差异有统计学意义（χ2=13.42,P=0.001）。hs-CRP是发生MACE的独立危险因素（OR=2.05,95%CI：1.24-3.39,P=0.005）。结论 hs-CRP是冠心病患者PCI术后心血管事件发生的独立危险因素,与PCI患者的血管病变相关,可作为PCI术后患者危险分层、病情及预后评估的指标。

Objective To investigate the value of hs-CRP in the assessment of risk stratification,coronary artery disease severity and prognosis for patients undergoing PCI with coronary heart disease.Methods A total of 150 coronary heart disease patients were recruited in the study,who had undergone PCI,and before that all the patients had undergone coronary angiography,and the levels of hs-CRP,TG,LDL-C,HDL-C,NT-proBNP and hs-cTnT were measured.Patients were divided into three groups according to the serum concentration of hs-CRP.Gemini score was used to determine the degree of stenosis.After PCI,patients were followed up for 6months,the major cardiovascular events（MACE）were recorded.The relationships between hs-CRP and other coronary risk factors,Gemini score,vasculopathy count,MACE events were analyzed.Results The serum concentrations of hs-CRP and HDL-C,hs-cTnT were significantly correlated（r=-0.17,0.42,P〈0.05）.The level of hs-CRP had increasing tendency with the increase of Gensini score,and the serum concentration of hs-CRP in severe vascular lesions group was significantly higher than both mild vascular lesions group and moderate vascular lesions group（P〈0.05）.The serum concentration of hs-CRP in single-vessel disease patients,double-vessel disease patients and multi-vessel disease patients were（4.64±5.39）,（9.86±8.75）,（14.93±10.34）mg/L,there was significant difference among them（P〈0.05）.The correlation coefficients of hs-CRP and Gemini score was 0.21（P〈0.05）,while hs-CRP and vasculopathy count was 0.18（P〈0.05）.The incidence of MACE in three groups were 18.52%,43.75%and 58.66%,which were statistically significantly difference（χ2=13.42,P=0.001）.Logistic regression showed that hs-CRP was an independent risk factor for MACE（OR=2.05,95%CI：1.24-3.39,P=0.005）.Conclusion Hs-CRP is an independent risk factor for coronary heart disease in patients with MACE after PCI,and hs-CRP was correlated with PCI patient′s vascular disease.Hs-CRP can be used as an indicator in the assessment of patient′s condition,PCI risk stratification and prognosis.