血清胱抑素C与冠心病患者预后的相关性

Correlation between serum cystatin C and prognosis of patients with coronary heart disease

目的探讨血清胱抑素C(Cys-C)与冠心病患者预后的相关性。方法冠状动脉造影确诊冠心病189例,出院后随访36个月。随访期间,46例发生主要心血管不良事件(MACE,A组),143例未见MACE(B组)。按Cys-C水平分为Ⅰ组(Cys-C<0.92 mg/L)、Ⅱ组(0.92 mg/L≤Cys-C<1.08 mg/L)、Ⅲ组(1.08 mg/L≤Cys-C≤1.30 mg/L)和Ⅳ组(Cys-C>1.30 mg/L),分析Cys-C与冠心病患者MACE的相关性。结果A组Cys-C水平高于B组[(1.18±0.09)mg/L vs.(0.98±0.06)mg/L](P<0.05)。Kaplan-Meier生存分析显示,Ⅳ组累积生存率低于Ⅰ、Ⅱ和Ⅲ组(P<0.01)。多因素Cox回归分析显示,年龄、糖尿病和Cys-C是冠心病患者3年MACE的独立影响因素(P<0.05)。结论血清Cys-C升高与冠心病患者MACE发生有关,可以作为一项评估冠心病预后的指标。

Objective To investigate the correlation between serum cystatin C(Cys-C)and the prognosis of the patients with coronary heart disease(CHD).Methods With coronary angiography,189 cases were diagnosed as CHD,who were followed up for 36 months after discharge.During the follow-up,46 cases had major adverse cardiovascular events(MACE)(group A),143 cases had no MACE(group B).According to serum Cys-C level,the patients were assigned into 4 groups ofⅠ(Cys-C<0.92 mg/L),Ⅱ(0.92 mg/L≤Cys-C<1.08 mg/L),Ⅲ(1.08 mg/L≤Cys-C≤1.30 mg/L)andⅣ(Cys-C>1.30 mg/L).The correlation between Cys-C and MACE was analyzed.ResultsSerum level of Cys-C in group A was higher than that in group B[(1.18±0.09)mg/L vs.(0.98±0.06)mg/L](P<0.05).Kaplan-Meier survival analysis showed that the cumulative survival rate in groupⅣwas lower than that in groups ofⅠ,ⅡandⅢ(P<0.01).Multivariate Cox regression analysis showed that age,diabetes and Cys-C were the independent factors for MACE in the patients with CHD(P<0.05).Conclusion Elevated serum Cys-C level is associated with MACE in the patients with CHD and can be used as an indicator to predict the prognosis of CHD.