血清超敏C反应蛋白、肿瘤坏死因子α对经皮冠状动脉介入术患者预后的影响

Effect of serum high-sensitivity C-reactive protein and tumor necrosis factor-alpha on prognosis of patients undergoing percutaneous coronary intervention

目的探讨血清超敏C反应蛋白(high-sensitivity C-reactive protein,hs-CRP)、肿瘤坏死因子α(tumor necrosis factor-alpha,TNF-α)对经皮冠状动脉介入术(percutaneous coronary intervention,PCI)患者预后的影响。方法选择我院2016年1月至2017年12月收治的197例行PCI治疗的急性冠状动脉综合征(acute coronary syndrome,ACS)患者的临床资料进行分析,将患者按PCI术后1年是否出现主要不良心血管事件(major adverse cardiovascular events,MACE)分为MACE组和非MACE组。比较两组患者PCI前及术后48 h血清hs-CRP、TNF-α浓度,采用Logistic回归分析法分析PCI后患者发生MACE的危险因素。结果PCI后1年随访结果,197例ACS患者PCI后发生MACE 39例,发生率为19.8%(39/197)。MACE组39例,非MACE组158例。MACE组和非MACE组患者PCI前血清hs-CRP分别为(9.70±4.71)、(7.50±4.61)mg/L,PCI后48 h分别为(15.37±5.01)、(12.16±4.38)mg/L,两组治疗前后及治疗后比较差异均有统计学意义(P均<0.01)。MACE组和非MACE组患者PCI前血清TNF-α分别为(33.1±8.9)、(25.7±8.0)ng/L,PCI后48 h分别为(47.6±8.1)、(32.4±7.6)ng/L,两组治疗前后及治疗后比较差异均有统计学意义(P<0.05或P<0.01)。Logistic回归分析结果表明,术前血清hs-CRP、TNF-α浓度为PCI患者发生MACE的危险因素[OR(95%CI)分别为2.069(1.715~3.358)、2.825(1.614~4.372),P值分别为0.020、0.027]。结论血清hs-CRP、TNF-α浓度与PCI患者预后有关,PCI术前血清CRP、TNF-α浓度均为发生MACE的危险因素,可作为发生MACE的独立预测因素。

Objective To investigate the effects of serum high-sensitivity C-reactive protein(hs-CRP)and tumor necrosis factor-alpha(TNF-α)on the prognosis of patients undergoing percutaneous coronary intervention(PCI).Methods From January 2016 to December 2017,197 patients with acute coronary syndrome(ACS)treated by PCI in our hospital were divided into MACE group(39 cases)and non-MACE group(158 cases)according to whether major adverse cardiovascular events(MACE)occurred after PCI.The serum levels of hs-CRP and TNF-αwere compared between the two groups before and 48 hours after PCI.The risk factors of MACE after PCI were analyzed by logistic regression analysis.Results One year follow-up results after PCI showed that 39 of 197 ACS patients had MACE after PCI,with an incidence of 19.8%(39/197).There were 39 cases in MACE group and 158 cases in non-MACE group.The serum hs-CRP of the MACE group and the non-MACE group before PCI were(9.70±4.71),(7.50±4.61)mg/L respectively,and 48 hours after PCI were(15.37±5.01),(12.16±4.38)mg/L,respectively.There were significant differences between the two groups(all P<0.01).The serum TNF-αlevels before PCI in MACE group and non-MACE group were(33.1±8.9),(25.7±8.0)ng/L,respectively,and 48 hours after PCI were(47.6±8.1),(32.4±7.6)ng/L,respectively.There were significant differences between the two groups(P<0.05 or P<0.01).The results of logistic regression analysis showed that preoperative serum hs CRP and TNF-αwere the risk factors of mace in PCI patients(OR(95%CI)was 2.069(1.715-3.358),2.825(1.614-4.372),P value was 0.020 and 0.027,respectively).Conclusion The serum levels of hs-CRP and TNF-αare related to the prognosis of patients with PCI.The serum levels of hs-CRP and TNF-αbefore PCI are risk factors for MACE,which can be used as independent predictors of MACE.