急性ST段抬高型心肌梗死患者急性期冠状动脉病变评分与血清胱抑素C水平的相关性

Correlation between coronary artery lesion score and serum cystatin C level in acute ST-segment elevation myocardial infarction patients

目的探讨急性ST段抬高型心肌梗死(STEMI)急性期冠状动脉病变评分与血清胱抑素C(CysC)水平的相关性。方法选取2016年9月～2018年4月在浙江省湖州市第一人民医院就诊的384例STEMI患者作为研究对象,记录患者的CysC水平,患者的冠状动脉病变评分采用冠状动脉狭窄程度(Gensini)评分,观察患者CysC水平与Gensini评分的相关性。结果随着病变程度增加,CysC水平逐渐降低,组间比较差异均有高度统计学意义(P <0.01)。Pearson相关分析结果显示,性别、居住地、饮酒与STEMI患者Gensini评分无相关性(P> 0.05);发病至介入时间、年龄、糖尿病、高血压、高脂血症、吸烟、冠心病家族史、体重指数、血糖、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、收缩压、舒张压、肌酸激酶同工酶(CK-MB)、脑钠肽(NT-proBNP)、超敏C反应蛋白(hs-CRP)与STEMI患者Gensini评分呈正相关(P <0.05),CysC、高密度脂蛋白胆固醇(HDL-C)、左室射血分数(LVEF)与Gensini评分呈负相关(P <0.05)。以Gensini评分为因变量,其他因素为自变量进行多变量Logistic回归分析,结果显示,LDL-C、CysC、hs-CRP是影响Gensini评分的独立危险因素(P <0.05)。结论 STEMI患者急性期CysC水平与Gensini水平呈负相关,有助于临床评估STEMI的病情严重程度。

Objective To investigate the correlation between coronary artery lesion score and serum cystatin C (CysC) level in acute ST-segment elevation myocardial infarction (STEMI). Methods A total of 384 STEMI patients admitted to Huzhou First People′s Hospital of Zhejiang Provmce from September 2016 to April 2018 were selected. The CysC level was recorded. Patients were assessed for coronary artery disease by coronary artery stenosis score (Gensini). The correlation between CysC level and Gensini score was observed. Results The CysC levels gradually decreased with the increase of lesion severity, and there was remarkably statistically significant difference among the groups (P < 0.01). The Pearson correlation analysis showed that gender, residence, alcohol consumption were not correlated with the Gensini score of STEMI patients (P > 0.05), and the gensini score was positively correlated with onset to intervening time, age, diabetes, hypertension, hyperlipidemia, smoking, family history of coronary heart disease, body mass index, blood glucose, total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), systolic blood pressure, diastolic blood pressure, creatine kinase isoenzyme (CK-MB), brain natriuretic peptide (NT-proBNP), hypersensitive c-reactive protein (hs-CRP)(P < 0.05), while the CysC, high density lipoprotein cholesterol (HDL-C), left ventricular ejection fraction (LVEF) were negatively correlated with Gensini score (P < 0.05). Gensini score was used as dependent variable, other factors as independent variables were analyzed in multiple regression analysis, and the results showed that LDL-C, CysC, hs-CRP were independent risk factors affecting Gensini evaluation (P < 0.05). Conclusion The CysC level in acute STEMI patients are negatively correlated with Gensini levels, which is helpful to assess the severity of STEMI.