CD42b、CD62p、hsCRP和Hcy与AMI患者冠脉病变程度的关系及对预后的预测价值

Relationship among CD42b, CD62p, hsCRP, Hcy and coronary lesion severity in AMI patients and their predictive value for prognosis

目的:分析CD42b、CD62p、hsCRP和Hcy与AMI患者冠脉病变程度的关系及对预后的预测价值。方法:根据SYNTAX评分,242例行PCI的AMI患者被分为低分组(65例,≤20分)、中分组(106例,21分~31分)和高分组(71例,≥32分),比较各组血浆CD42b、CD62p、hsCRP和Hcy水平。Pearson相关分析上述指标与SYNTAX评分的相关性;比较各组MACCE发生率;以ROC曲线分析上述指标对MACCE的预测价值。结果:与低分组比较,中分、高分组血浆CD42b水平[(87.71±5.94)比(68.93±3.45)比(55.54±4.31)]显著降低,血浆CD62p[(21.63±3.29)比(27.47±3.01)比(37.81±3.78)]和Hcy[(13.14±1.60)μmol/L比(17.31±1.93)μmol/L比(22.30±2.73)μmol/L]水平显著升高,P均=0.001。Pearson相关分析显示血浆CD42b水平与AMI患者SYNTAX评分显著负相关(r=-0.885,P=0.001),血浆CD62p和Hcy水平与SYNTAX评分显著正相关(r=0.799,0.801,P均=0.001)。与低分、中分组比较,高分组MACCE发生率(9.23%、18.87%比35.21%)显著升高,P=0.001,0.014。ROC曲线显示血浆CD42b、CD62p和Hcy预测AMI患者发生MACCE的最佳截断值分别为69.72、28.33和20.77μmol/L,灵敏度分别为64.7%、73.1%和75.2%,特异度分别为69.3%、80.5%和63.8%。结论:血浆CD42b水平和AMI患者SYNTAX评分显著负相关,CD62p及Hcy水平与SYNTAX评分显著正相关,且对预后MACCE事件有一定的预测价值。

Objective:To analyze relationship among CD42b,CD62p,hsCRP,Hcy and coronary lesion severity in AMI patients and their predictive value for prognosis.Methods:According to SYNTAX score,the 242 AMI patients undergoing PCI were divided into low score group(n=65,≤20 scores),medium score group(n=106,21~31scores)and high score group(n=71,≥32 scores).Plasma levels of CD42b,CD62p,hsCRP and Hcy were compared among above groups.Pearson correlation analysis was used to analyze correlation between plasma levels of above indexes and SYNTAX score;incidence rate of MACCE was compared among all groups;ROC curve was used to analyze predictive value of above indexes for MACCE.Results:Compared with low score group,there was significant reduction in plasma CD42b level[(87.71±5.94)vs.(68.93±3.45)vs.(55.54±4.31)],and significant rise in plasma levels of CD62p[(21.63±3.29)vs.(27.47±3.01)vs.(37.81±3.78)]and Hcy[(13.14±1.60)μmol/L vs.(17.31±1.93)μmol/L vs.(22.30±2.73)μmol/L]in medium score group and high score group,P=0.001 all.Pearson correlation analysis indicated that plasma CD42b level was significant inversely correlated with SYNTAX score(r=-0.885,P=0.001),and plasma levels of CD62p and Hcy were significant positively correlated with SYNTAX score(r=0.799,0.801,P=0.001 both)in AMI patients.Compared with low and medium score group,there was significant rise in incidence rate of MACCE(9.23%,18.87%vs.35.21%)in high score group,P=0.001,0.014.ROC curve indicated optimal cutoff points of plasma CD42b,CD62p and Hcy was 69.72,28.33 and 20.77μmol/L,sensitivity of them was 64.7%,73.1%and 75.2%respectively,specificity of them was 69.3%,80.5%and 63.8%respectively in predicting MACCE in AMI patients.Conclusion:Plasma CD42b level is significant inversely correlated with SYNTAX score,while CD62p and Hcy levels are significant positively correlated with SYNTAX score in AMI patients.They possess certain predictive value for MACCE.