血清超敏C反应蛋白与前白蛋白比值对急性心肌梗死并发急性心衰的预测价值

Prediction value of the ratio of serum high-sensitivity C-reactive protein and prealbumin for acute myocardial infarction complicated with acute heart failure

目的：通过统计急性心肌梗死患者血清超敏C反应蛋白（hs-CRP）、前白蛋白（PAB）以及两者比值,分析其对急性心肌梗死及术后并发急性心衰的预测价值。方法：选取2013年1月-2015年1月在河北省秦皇岛市抚宁县人民医院住院治疗的急性心肌梗死患者100例作为研究对象。分别记录入院次日以及PCI术后患者血清PAB与hs-CRP数值,对比手术前后PAB数据变化、术后心血管事件（心衰）发生与否PAB和hs-CRP的变化情况以及hs-CRP与PAB比值预测急性心肌梗死并发急性心衰的价值。结果：100例心肌梗死患者术后PAB由（0.19±0.05）升为（0.24±0.06）,差异具有统计学意义（P〈0.05）;40例术后发生心血管事件（心衰）,发生率为40%;术后未发生心血管事件（心衰）患者PAB明显升高,hs-CRP明显降低,差异具有统计学意义（P〈0.05）;经过Logistic回归单变量分析急性心肌梗死并发心衰与糖尿病、PAB、hs-CRP以及In（hs-CRP/PAB）相关,多变量分析显示与In（hs-CRP/PAB）相关。结论：急性心肌梗死患者hs-CRP升高,PAB降低,术后PAB相对升高,术后发生心血管（心衰）与否hs-CRP和PAB数据有不同程度变化,In（hs-CRP/PAB）与急性心肌梗死并发心衰相关,可作为其预测指标。

Objective： Through counting serum high-sensitivity C-reactive protein （hs-CRP）, prealbumin （PAB） and the ratio of the two to analyze its predictive value for acute myocardial infarction complicated with postoperative acute heart failure. Methods： 100 cases of acute myocardial infarction patients treated in our hospital from January 2013 to January 2015 were selected as research objects. Serum PAB and hs-CRP values on the second day of admission as well as after undergoing PCI surgery were recorded respectively. Then PAB data changes before and after surgery, PAB and hs-CRP changes with or with- out postoperative cardiovascular events （heart failure） as well as the value of the ratio of hs-CRP and PAB on prediction of a- cute myocardial infarction complicated with acute heart failure was compared. Results： Postoperative PAB in 100 cases of myo- cardial infarction patients increased from （0.19±0.05） to （0.24±0.06）, and the differences had statistical significance （P〈0.05）; 40 cases had postoperative cardiovascular events （heart failure） with an incidence of 40%; PAB in patients without postoperative cardiovascular events （heart failure） increased significantly, hs-CRP decreased significantly, and the differences had statistical significance （P〈0.05）. Logistic regression univariate analysis showed that acute myocardial infarction complicated with heart failure was associated with diabetes, PAB, hs-CRP and In （hs-CRP/PAB）, and multivariate analysis showed that it was associated with In （hs-CRP/PAB）. Conclusion： In patients with acute myocardial infarction, hs-CRP increases, but PAB decreases, postoperative PAB increases relatively. Hs-CRP and PAB data shows different degrees of change according to presence of absence of postoperative cardiovascular （heart failure）, in （hs-CRP/PAB） is associated with occurrence of acute myocardial infarction complicated with heart failure and can be used as its prediction index.