摘要
目的:研究血清高敏C-反应蛋白(high sensitivity C-reactive protein,hs-CRP)与白蛋白(albumin,ALB)比值对预测急性ST段抬高型心肌梗死(STEMI)患者预后的预测价值。方法:回顾性分析新疆医科大学第一附属医院收治的225例急性STEMI患者的病例资料,采集患者急诊入院后首管静脉血,检测血清hs-CRP与ALB,并计算出hs-CRP/ALB比值。对所有患者进行随访,平均随访3年,观察并记录患者主要不良心血管事件(MACE)的发生情况。应用Cox单因素及多因素回归分析包括年龄、性别、吸烟史、冠心病家族史、高血压、糖尿病、血脂异常、体质指数(BMI)、心率、收缩压、舒张压、白细胞(WBC)、B型利钠肽(BNP)、总胆固醇(TC)、三酰甘油(TG)、hs-CRP/ALB、左室射血分数(LVEF)等多项因素与急性STEMI患者MACE发生的关系。结果:hsCRP/ALB预测急性STEMI患者随访期发生MACE的受试者工作特征曲线下面积(AUC)为0.70(95%CI:0.598~0.90,P<0.001),最佳截点为0.38,灵敏度为68.1%、特异度为84.7%,hs-CRP/ALB≥0.38组发生MACE的比例显著高于hs-CRP/ALB<0.38组(P<0.05)。多因素Cox回归分析显示:hs-CRP/ALB≥0.38是急性STEMI患者随访期发生不良预后的独立危险因素。Kaplan-Meier生存分析显示,hs-CRP/ALB≥0.38组MACE发生率显著高于hs-CRP/ALB<0.38组(log-rank=5.68,P=0.017)。结论:hs-CRP/ALB对急性STEMI患者预后有较高的预测价值,可作为此类患者不良临床结局的预测指标。
Objective:To study the predictive value of serum high sensitivity C-reactive protein(hs-CRP)and albumin(ALB)ratio on the prognosis of the patients with acute ST elevation myocardial infarction(STEMI).Method:We selected 225 patients in emergency admission with acute STEMI in the first affiliated hospital of Xinjiang Medical University from September 2012 to September 2013,who all have hs-CRP and ALB,hs-CRP/ALB.All patients were followed up,observed and recorded with major adverse cardiovascular events(MACE).Cox Univariate and Multivariate regression analysis were used.Result:Multivariate Cox regression analysis showed:hsCRP/ALB≥0.38 was the independent risk factors of patients with acute STEMI occurring adverse prognosis during follow-up period.Kaplan-Meier Survival Analysis showed that hs-CRP/ALB≥0.38 group had a significantly higher incidence of MACE than hs-CRP/ALB0.38 groups(Log-rank=5.68,P=0.017).Conclusion:hs-CRP/ALB has a high predictive value in adverse clinical outcomes of patients with STEMI.
作者
叶宗伟
刘芬
赵倩
李晓梅
周欣荣
陈清杰
单春方
王钧
杨毅宁
YE Zongwei;LIU Fen;ZHAO Qian;LI Xiaomei;ZHOU Xinrong;CHEN Qingjie;SHAN Chunfang;WANG Jun;YANG Yining(The First Affiliated Hospital of Xinjiang Medical University,Urumqi,830011,China)
出处
《临床心血管病杂志》
CAS
CSCD
北大核心
2018年第8期760-764,共5页
Journal of Clinical Cardiology
基金
新疆维吾尔自治区科技支疆项目(No:2016E02072)
关键词
心肌梗死
高敏C反应蛋白
白蛋白
预后
myocardial infarction
high sensitivity C-reactive protein
albumin
prognosis