降钙素原与稳定性冠心病患者冠状动脉粥样硬化的关系探讨

Relationship between procalcitonin and coronary atherosclerosis in patients with stable coronary heart disease

目的:探讨在稳定性冠心病患者中血清降钙素原(PCT)水平与SYNTAX积分(SXs)之间的关系。方法:共纳入400例明确诊断冠心病患者,测量血清降钙素原(PCT)和高敏C反应蛋白(hsCRP)水平,应用SYNTAX(SXs)评分系统计算冠状动脉粥样硬化负荷,SXs<23(n=320)的患者被归类为低SXs组,SXs≥23(n=80)的患者被归类为高SXs组。结果:高SXs组与低SXs组相比,血清PCT水平较高(P=0.001)。ROC曲线分析显示,对于高SXs(曲线下面积:0.753,敏感度:72.5%,特异度:61.3%),PCT的临界值为0.0335μg/L。多因素Logistic分析后,PCT与目前吸烟(OR=2.237,P=0.027),TG(OR=1.005,P=0.001)和hs-CRP(OR=1.119,P=0.018)是高SXs的预测因子(OR=3.021,95%CI:1.492~6.097,P=0.002)。结论:血清PCT与SXs独立且正相关,血清PCT水平升高可能有助于确定稳定性冠心病患者的高冠状动脉粥样硬化负荷。

Objective： To investigate the relationship between serum procalcitonin（ PCT） level and SYNTAX integral（ SXs） in patients with stable coronary heart disease. Methods： 400 patients with definite diagnosis of coronary heart disease were enrolled in this study. Serum levels of procalcitonin（ PCT） and highsensitivity C-reactive protein（ hs-CRP） were measured. Coronary atherosclerosis load was calculated using SYNTAX（ SXs） Patients with 23（ n = 320） were classified as low SX and those with SXs ≥23（ n = 80） were categorized as high SX. Results： Serum PCT levels were higher in the high SXs group than in the low SXs group（ P = 0. 001）. ROC curve analysis showed that the cut-off value of PCT was 0. 0335 μg/L for high SXs（ area under the curve： 0. 753,sensitivity： 72. 5%,specificity： 61. 3%）. After multivariate Logistic analysis,PCT was independent of high SXs with current smoking（ OR = 2. 237,P = 0. 027）,triglycerides（ OR =1. 005,P = 0. 001） and hs-CRP Predictors（ OR = 3. 021,95% CI： 1. 492-6. 097,P = 0. 002）. Conclusion：Serum PCT is independent and positively correlated with SXs. Elevated serum PCT level may be helpful to determine the high coronary atherosclerosis load in patients with stable coronary heart disease.