摘要
目的:研究超敏 C 反应蛋白(hs‐CRP)、脂蛋白相关的磷脂酶 A2酶活性(Lp‐PLA2)、D‐二聚体(DD)与冠状动脉粥样硬化性心脏病(CHD)患者预后的关系。方法选取2009年8月至2010年9月鄂州二医院和鄂钢医院行冠状动脉造影明确诊断为 CHD 的住院患者480例,记录患者入院后24 h 内空腹 hs‐CRP 、Lp‐PLA2、DD 及其他临床资料。于2012年8月至10月进行电话、门诊或者住院随访,了解心脏不良事件的发生情况。依据是否发生心脏不良事件进行单因素分析和多因素 Logistic 回归分析。结果(1)成功随访458例(95.4%),随访时间为(30.8±3.9)个月。72例发生不良事件(15.7%),死亡14例(3.1%)。(2)单因素分析显示:性别、高血压、糖尿病、hs‐CRP 、Lp‐PLA2、DD 、左心室舒张末期直径(LVEDD)是心脏不良事件发生的危险因素(P <0.05)。(3)多因素Logistic 逐步回归分析显示性别、hs‐CRP 、Lp‐PLA2、DD 水平进入回归方程,与未发生不良事件组相比,发生不良事件组的性别 OR 值1.647(95% CI :1.543~1.759,P <0.001),hs‐CRP 的 OR 值为2.235(95% CI :2.064~2.420, P<0.001),Lp‐PLA2的 OR 值为0.644(95% CI :0.569~0.729,P <0.001),DD 的 OR 值为1.918(95% CI :1.594~2.309,P<0.001)。结论 hs‐CRP 、Lp‐PLA2、DD 水平可以预测 CHD 患者的不良预后。
Objective To explore the relationship between hypersensitive C reactive protein (hs‐CRP ) , 1ipoprotein associated phospholipase A2(Lp‐PLA2) and D‐dimer(DD) with the prognosis in the patients with ather‐osclerotic coronary heart disease(CHD) .Methods A total of 480 consecutive patients with CHD diagnosed by coro‐nary arteriography in E′zhou Second Hospital or E′zhou Iron and Steel Co Hospital from August 2009 to September 2010 were selected .The fasting blood hs‐CRP ,Lp‐PLA2 and DD levels within 24 h after admission and others clinical data were recorded .The telephone ,outpatient department and inpatient department follow up was conducted from August to October 2010 to inquiry the occurrence of adverse cardiac events .Results (1)A total of 458 cases were successfully followed up(95 .4% ) for a mean period of(30 .8 ± 3 .9) months ,including 72 cases(15 .7% ) of adverse cardiac events and 14 cases(3 .1% ) of deaths .(2)The univariate analysis showed that sex ,hypertension ,diabetes ,hs‐CRP ,Lp‐PLA2 ,DD and left ventricular end‐diastolic diameter(LVEDD) were the risk factors of adverse cardiac e‐vent occurrence(P〈0 .05) .(3) The multifactor Logistic regression analysis revealed that sex ,hs‐CRP ,Lp‐PLA2 and DD levels entered the equation .Compared with the no adverse event group ,the OR value of sex ,hs‐CRP ,Lp‐PLA2 and DD in the adverse event group were 1 .647(95% CI :1 .543 - 1 .759 ,P 〈0 .001) ,2 .235(95% CI :2 .064 - 2 .420 , P〈 0 .001) ,0 .644(95% CI :0 .569 - 0 .729 ,P 〈 0 .001)and 1 .918 (95% CI :1 .594 - 2 .309 ,P 〈0 .001)respectively . Conclusion hs‐CRP ,Lp‐PLA2 and DD could predict the adverse outcomes of CHD patients .
出处
《检验医学与临床》
CAS
2015年第15期2180-2181,2184,共3页
Laboratory Medicine and Clinic
基金
2013年鄂州市高新技术产业化项目(2013EC05)