高敏C反应蛋白对颈动脉内膜剥脱术早期预后的影响分析

Effect of high sensitivity C-reactive protein on early prognosis of carotid endarterectomy

目的探讨血清高敏C反应蛋白(Hs-CRP)水平对颈动脉狭窄行颈动脉内膜剥脱(CEA)术治疗早期预后的影响。方法回顾性分析184例颈动脉狭窄行CEA术治疗患者的临床资料。术前检测血清Hs-CRP水平;通过门诊或电话随访了解患者术后早期(<30 d)发生的不良事件。采用单因素分析和多因素Logistic回归分析Hs-CRP水平增高是否为患者早期预后的独立危险因素。结果本组184例患者共进行217次CEA术。有36例患者术前Hs-CRP水平高,其术后早期不良事件发生率为6.5%(12/184)。单因素分析显示,Hs-CRP水平增高和对侧颈动脉狭窄患者的术后早期预后不良的比例,分别明显高于Hs-CRP水平正常及不狭窄患者(均P<0.05)。Logistic多因素回归分析显示,Hs-CRP水平增高是CEA术后发生早期不良事件的独立危险因素(OR值4.733,95%CI 1.428~15.686;P<0.05)。结论CEA术是安全有效的,但是对术前Hs-CRP高水平的患者需警惕其早期不良事件的发生。

Objective To investigate the influence of serum high sensitive C-reactive protein(Hs-CRP)level on the early prognosis of carotid artery stenosis treated by carotid endarterectomy(CEA).Methods The clinical data of 184 patients with carotid artery stenosis treated by CEA were analyzed retrospectively.Serum Hs-CRP level was detected before operation.Through outpatient or telephone follow-up to understand the early postoperative adverse events(<30 days).Univariate analysis and multivariate Logistic regression were used to analyze whether the increased Hs-CRP level was an independent risk factor for early prognosis.Results A total of 217 CEA operations were performed in 184 patients.There were 36 patients with high preoperative Hs-CRP level,and the incidence of early postoperative adverse events was 6.5%(12/184).Univariate analysis showed that the proportion of patients with high Hs-CRP level and contralateral carotid stenosis with poor early postoperative prognosis was significantly higher than that of patients with normal Hs-CRP level and without stenosis(all P<0.05).Logistic regression analysis showed that the increased Hs-CRP level was an independent risk factor for early adverse events after CEA(OR 4.733,95%CI 1.428-15.686,P<0.05).Conclusion CEA is safe and effective,but the patients with high preoperative Hs-CRP level should be alert to the occurrence of early adverse events.