血清超敏C-反应蛋白与前白蛋白比值对急性心肌梗死患者并发心力衰竭的预测价值研究

Predictive Value of Serum High-sensitivity C-reactive Protein and Prealbumin Ratio in Patients with Acute Myocardial Infarction Complicated with Heart Failure

目的分析血清超敏C-反应蛋白(hs-CRP)/前白蛋白(PAB)对急性心肌梗死(acute myocardial infarction,AMI)患者并发心力衰竭(heart failure,HF)的预测价值。方法选取我院2014年2月—2016年10月收治的120例AMI,根据Killip心功能分级≥Ⅱ级作为并发HF的依据,将120例分为HF组70例和非HF组50例。比较两组患者一般资料,分析AMI并发HF的影响因素;观察HF组中不同Killip心功能分级患者hs-CRP及PAB水平,并分析其与Killip心功能分级的相关性;分析hs-CRP/PAB对AMI并HF的诊断效能。结果年龄、NT-pro BNP、hs-CRP、PAB、hs-CRP/PAB是AMI并发HF的影响因素。HF组随着Killip心功能分级的升高hs-CRP水平逐渐上升,PAB水平逐渐下降,差异均有统计学意义(P<0.01);HF组hs-CRP水平和Killip心功能分级呈正相关(r=0.567,P=0.012),PAB水平和Killip心功能分级呈负相关(r=-0.466,P=0.025)。hs-CRP/PAB诊断AMI并发HF的灵敏度为96.98%,特异度为95.68%,受试者工作特征曲线下面积为0.98,与其他影响因素诊断效能比较差异均有统计学意义(P<0.05)。结论 AMI并发HF时hs-CRP、PAB水平升高,hs-CRP/PAB与AMI合并HF密切相关,hs-CRP/PAB比值越高提示发生HF的风险越大,可作为AMI并发HF的预测指标。

Objective To analyze the predictive value of serum high-sensitivity C-reactive protein and prealbumin ra-tio in patients with acute myocardial infarction （ AMI） complicated with heart failure （ HF ） . Methods The clinical data of 120 patients with acute myocardial infarction were retrospectively analyzed admitted to our hospital from February 2014 to Oc-tober 2016, according to the Killip cardiac function classification II or higher level as a basis for the concurrent HF, 120 pa-tients were divided into HF group and control group, 70 cases of control group and 50 cases of HF group. We compare the data of the two groups and analyze the related factors of AMI and HF. To observe the levels of hs-CRP and PAB in HF group, and analyze the correlation between them. Results Age, NT-proBNP, serum hs-CRP, PAB were the factors affecting AMI. The HF group gradually increased the level of hs-CRP with the function of Killip, and the PAB level gradually decreased, and the comparison with non-hr group was statistically significant （ P 〈 0. 01） . HF group hs-CRP level and Killip cardiac function grading were positively correlated （ r = 0. 567 , P = 0. 012） , PAB level and Killip cardiac function grading were negatively cor-related （r = - 0. 466 , P = 0. 025 ） . The sensitivity of hs-CRP/PAB in the diagnosis of AMI was 96. 98% , the specificity was 95. 68% , the area under the ROC curve was 0. 98, and the difference of diagnostic value of other factors was statistically sig-nificant （P 〈0. 05） . Conclusion The hs-CRP and PAB levels were raised when AMI was concurrent with HF, and hs-CRP/ PAB was closely related to AMI combined with HF. The higher the ratio of HF, the greater the risk of HF, which could be used as the predictor of AMIs concurrent HF.