血清胱抑素C及超敏C反应蛋白对冠心病PCI术患者预后评估的意义

Significance of serum cystatin C and high sensitivity C-reactive protein in prognosis review in patients with coronary heart disease after PCI

目的探讨血清胱抑素C(Cys-C)、超敏C反应蛋白(hs-CRP)对冠心病经皮冠状动脉介入术(PCI)患者预后评估的意义。方法选择2015年1月~2017年1月于北京市昌平区中西医结合医院心内科收治的140例稳定性心绞痛患者作为研究对象,按患者是否进行PCI治疗分为PCI组94例和非PCI组46例。非PCI组给予药物保守治疗,PCI组给予PCI术治疗。干预前、干预后2周、干预后4周进行Cys-C、hs-CRP检测。PCI组所有患者均进行门诊和电话随访6个月,记录非致死性心肌梗死或再次血运重建、心力衰竭再入院、心绞痛再复发再入院等主要心血管不良事件(MACE)的发生情况。比较心血管事件组和非心血管事件组患者干预前、干预后2周、干预后4周的Cys-C、hs-CRP水平。结果组内比较,PCI组不同时间血清Cys-C、hs-CRP差异具有统计学意义(P<0.05),干预后2周、4周的Cys-C、hs-CRP明显高于干预前(P<0.05)。非PCI组不同时间血清Cys-C、hs-CRP差异无统计学意义(P>0.05)。PCI组干预后2周、4周的Cys-C、hs-CRP明显高于非PCI组(P<0.05)。心血管事件组和非心血管事件组患者不同时间血清Cys-C、hs-CRP差异具有统计学意义(P<0.05),心血管事件组干预后2周、4周的Cys-C、hs-CRP明显高于非心血管事件组(P<0.05)。结论冠心病患者PCI术后Cys-C、hs-CRP水平持续升高,术后Cys-C、hs-CRP越高,患者临床预后越差。

Objective To investigate the significance of serum cystatin C(Cys C)and high sensitivity C-reactive protein(hs-CRP)to prognosis review in patients with coronary heart disease(CHD)after percutaneous coronary intervention(PCI).Methods CHD patients(n=140)were chosen from Department of Cardiology in Hospital of Integrated Chinese and Western Medicine in Beijing Changping District from Jan.2015 to Jan.2017,and then divided,according whether undergone or not PCI,into PCI group(n=94)and non-PCI group(n=46).The non-PCI group was treated with conservative medication,and PCI group was treated with PCI operation.The levels of serum Cys-C and hs-CRP were detected before,and 2 weeks and 4 weeks after PCI,and PCI group was followed up for 6 months through outpatient department or telephone.The incidence of major adverse cardiovascular events(MACE)were recorded,including non-fatal myocardial infarction,re-revascularization,readmission due to heart failure and readmission due to re-relapse of angina pectoris.And according to follow-up results,PCI group was divided into MACE subgroup and non-MACE subgroup.The levels of serum Cys-C and hs-CRP were compared between MACE subgroup and non-MACE subgroup before,and 2 weeks and 4 weeks after PCI.Results The difference in levels of serum Cys-C and hs-CRP at different time points had statistical significance(P<0.05),and levels of serum Cys-C and hs-CRP were significantly higher after operation for 2 and 4 weeks(P<0.05)in PCI group.The difference in levels of serum Cys-C and hs-CRP at different time points had no statistical significance(P>0.05)in non-PCI group.The levels of serum Cys-C and hs-CRP were significantly higher in PCI group than those in non-PCI group after operation for 2 and 4 weeks(P<0.05).The difference in levels of serum Cys-C and hs-CRP at different time points had statistical significance(P<0.05)between MACE subgroup and non-MACE subgroup,and levels of serum Cys-C and hs-CRP were significantly higher in MACE subgroup than those in non-MACE subgroup after operation for 2 and 4 weeks(P<0.05).Conclusion The levels of serum Cys-C and hs-CRP increase continuously in CHD patients,and the higher the levels of serum Cys-C and hs-CRP,the poorer the clinical prognosis.