高敏C反应蛋白/清蛋白比值及血浆和肽素对冠心病合并慢性心力衰竭患者主要不良心血管事件的预测价值

Predictive value of high sensitivity C-reactive protein/albumin ratio and plasma copeptin on major adverse cardiovascular events in patients with coronary heart disease and chronic heart failure

目的探讨高敏C反应蛋白/清蛋白比值及血浆和肽素(CPP)对冠心病合并慢性心力衰竭患者发生主要不良心血管事件(MACE)的预测价值。方法选择2018年3月~2019年6月在济南市槐荫人民医院因冠心病合并慢性心力衰竭住院的86例患者,根据6个月内是否发生MACE将其分为MACE组(36例)与非MACE组(50例)。收集所有患者的资料,检测患者的血清脑利钠肽(BNP)、CPP水平、高敏C反应蛋白/清蛋白比值、左室射血分数(LVEF),并对高敏C反应蛋白/清蛋白比值及CPP做受试者工作特征(ROC)曲线,评估高敏C反应蛋白/清蛋白比值及CPP对冠心病合并慢性心力衰竭患者发生MACE的预测价值。结果MACE组患者的高敏C反应蛋白/清蛋白比值及血浆BNP、CPP水平均高于非MACE组,LVEF低于非MACE组,差异有统计学意义(P<0.05)。高敏C反应蛋白/清蛋白比值预测冠心病合并慢性心力衰竭患者发生MACE的曲线下面积(AUC)=0.826,P=0.000,95%CI(0.735~0.917),具有一定诊断意义。血浆CPP预测冠心病合并慢性心力衰竭患者发生MACE的AUC=0.714,P=0.000,95%CI(0.604~0.824),具有一定诊断意义。高敏C反应蛋白/清蛋白比值及血浆CPP联合预测冠心病合并慢性心力衰竭患者发生MACE的AUC=0.865,诊断意义优于上述两个单独指标。结论高敏C反应蛋白/清蛋白比值及CPP可作为临床早期预测冠心病合并慢性心力衰竭患者发生MACE的生物标志物。

Objective To investigate the predictive value of high sensitivity C-reactive protein and albumin ratio and plasma copeptin(CPP)on major adverse cardiovascular events(MACE)in patients with coronary heart disease and chronic heart failure.Methods Eighty-six hospitalized patients with coronary heart disease and chronic heart failure in People′s Hospital of Huaiyin Ji′nan from March 2018 to June 2019 were selected.According to the occurrence of MACE within 6 months,the patients were divided into the MACE group(36 cases)and the non-MACE group(50 cases).The data of all patients were collected,the serum brain natriuretic peptide(BNP),CPP levels,high-sensitivity C-reactive protein/albumin ratio and left ventricular ejection fraction(LVEF)were detected,and receiver operating characteristic(ROC)curve was used to evaluate the predictive value of high-sensitivity C-reactive protein/albumin ratio and CPP for MACE in patients with coronary heart disease and chronic heart failure.Results The high-sensitivity C-reactive protein/albumin ratio,plasma BNP and CPP levels of the MACE group were higher than those of the non-MACE group,and the LVEF was lower than that of the non-MACE group,the differences were statistically significant(P<0.05).The area under the curve(AUC)of MACE in patients with coronary heart disease and chronic heart failure predicted by the high-sensitivity C-reactive protein/albumin ratio was 0.826,P=0.000,95%CI(0.735-0.917),which had certain diagnostic significance.The AUC of MACE in patients with coronary heart disease and chronic heart failure predicted by the plasma CPP was 0.714,P=0.000,95%CI(0.604-0.824),which had certain diagnostic significance.The AUC was 0.865 in the occurrence of MACE in patients with coronary heart disease and chronic heart failure predicted by combination of high-sensitivity C-reactive protein/albumin ratio and plasma CPP,which was better than the above two independent indicators.Conclusion The high-sensitivity C-reactive protein/albumin ratio and CPP can be used as biomarkers for early prediction of MACE in patients with coronary heart disease and chronic heart failure.