非ST段抬高型急性冠状动脉综合征患者血清胱抑素C与SYNTAX评分的相关性研究

Relationship between serum cystatin C level and SYNTAX score in patients with non-ST segment elevation acute coronary syndrome

目的：探讨非ST段抬高型急性冠状动脉综合征（NSTE- ACS）患者血清胱抑素C（CysC）水平与冠状动脉病变严重程度的关系。方法选择行冠状动脉造影的NSTE- ACS患者202例，分为不稳定性心绞痛（UAP组）124例，非ST段抬高型心肌梗死（NSTEMI组）78例，54例冠状动脉造影阴性的患者为对照组。将NSTE- ACS患者根据冠状动脉造影结果分为（SYNTAX）评分低分组（1-22分）69例、中分组（23-32分）92例、高分组（＞32分）41例。所有患者冠状动脉造影前均检测血清CysC，比较各组的CysC水平并分析CysC与SYNTAX评分的相关性。结果 UAP组、NSTEMI组患者CysC[（1.26±0.38）、（1.38±0.55）mg/L]高于对照组[（0.92±0.26）mg/L]，差异有统计学意义（t=5.32、6.39，均P＜0.05）。中分组和高分组CysC[（1.30±0.25）、（1.56±0.43）mg/L]高于低分组[（1.02±0.31）mg/L]，差异有统计学意义（t=2.35、6.58，均 P＜0.05）。Pearson线性回归分析结果显示NSTE- ACS患者CysC与SYNTAX评分呈正相关（r=0.78，P＜0.01）。多因素logistic回归分析结果显示，年龄和糖尿病是SYNTAX评分＞32分最强的预测因素（P＜0.01），血清CysC和LDL- C是SYNTAX评分＞32分的独立预测因素（P＜0.05）。结论 NSTE- ACS患者CysC水平具有预测SYNTAX评分的作用。

Objective To evaluate the relationship between serum cystatin C level and the severity of coronary lesion in patients with non- ST segment elevation acute coronary syndrome （NSTE- ACS）. Methods 202 patients with NSTE- ACS underwent coronary angiography （CAG） and were divided into unstable angina pectoris （UAP） group（n=124） and non- ST segment elevation myocardial infarction （NSTEMI） group （n=78）. 54 persons with negative result of CAG served as control group. According to SYNTAX score, NSTE- ACS patients were divided into low- risk group（1-22scores, n=69）, intermediate- risk group （23-32scores, n=92） and high- risk group （〉32scores, n=41）. Serum cystatin C was measured before CAG and compared between groups. The relation between serum cystatin C and SYNTAX score was determined. Results The serum cystatin C level was significantly higher in UAP group and NSTEMI group than in control group, and significantly higher in the intermediate- and high- risk groups than in the low- risk group. The Pearson correlation analysis showed that SYNTAX score was positively correlated to serum cystatin C level （r=0.78, P〈0.01）. Multivariate logistic regression analysis showed that age and diabetes mel itus were the strongest predictive factor and serum cystatin C and LDL- C levels were independent predictive factors of SYNTAX score〉32 （P〈0.01, P〈0.05）. Conclusion The level of serum cystatin C may be used to predict SYNTAX score in patients with NSTE- ACS.