C反应蛋白与白蛋白比值对于经皮冠状动脉介入术后心肌梗死患者预后的影响

The association of ratio of serum C-reactive protein to albumin with the prognosis of patients with myocardial infarction after primary percutaneous coronary intervention

目的探讨血清C反应蛋白(CRP)与白蛋白(ALB)比值(CRP/ALB)与经皮冠状动脉介入术(PCI)后急性心肌梗死患者预后的关系。方法回顾性分析2012年1月至2015年12月收治的急性心肌梗死并行急诊PCI术患者103例。根据术后1年内是否发生心血管事件,分为事件组51例和对照组52例。对CRP/ALB、肌钙蛋白I(c Tn I)、肌酸激酶同工酶(CK-MB)、左心室射血分数(LVEF)与心血管事件之间的关系作logistic回归分析。结果事件组PCI术后24h内血清CRP[(14.77±10.38)mg/L]、CRP/ALB(0.37±0.26)高于对照组[(8.86±8.98)mg/L、(0.22±0.22)],差异均有统计学意义(P<0.01)。多因素logistic回归分析表明:CRP/ALB增大是急性心肌梗死患者行急诊PCI术后发生心血管事件的独立危险因素(OR=14.244,95%CI:1.944~104.350,P<0.01)。结论急性心肌梗死行急诊PCI术患者术后24h内CRP/ALB增大预示1年内发生心血管事件相关的风险增加。

Objective To investigate the association of the ratio of C-reactive protein(CRP)to albumin(ALB)with prognosis of patients with acute myocardial infarction(AMI)after primary percutaneous coronary intervention(PCI).Methods103AMI patients underwent PCI from January2012to December2015were enrolled and divided into event group(51patients)and control group(52patients)according to the cardiovascular events within one year after PCI.Logistic regression analysis were performed to determine the association of the ratio of CRP/ALB,troponin I,CK-MB and left ventricular ejection with cardiovascular events.Results The serum CRP and the ratio of CRP/ALB within24hours post PCI were significantly higher in event group than in control group.[(14.77±10.38)mg/L,(0.37±0.26)vs.(8.86±8.98)mg/L,(0.22±0.22),respectively,all P<0.01].Logistic regression analysis showed that higher CRP/ALB was an independent predictor of cardiovascular events in patients with AMI after primary PCI Odds Ratio=14.244),95%confidence interval1.944～104.350,P<0.01).Conclusion Higher ratio of CRP/ALB within24h after PCI may predict higher risk of cardiovascular events within one year.