冠心病心绞痛患者PCI围手术期CRP、Lp(a)水平检测及其与心肌损伤的相关性

Detection of CRP and Lp(a)levels and correlation with myocardial injury during PCI perioperative period in patients with coronary heart disease and angina pectoris

目的观察冠心病心绞痛患者经皮冠状动脉介入术(PCI)治疗围手术期C反应蛋白(CRP)、脂蛋白(a)[Lp(a)]水平检测及其与心肌损伤的相关性。方法回顾性分析2020年3月至2021年3月在广东省潮州市中心医院(以下简称“我院”)诊治的冠心病心绞痛患者80例的临床资料,依据心绞痛类型,分为稳定组(稳定型心绞痛,38例)与不稳定组(不稳定型心绞痛,42例),另选择同期在我院体检的健康人群50名为对照组。采用免疫散射比浊法检测CRP水平,采用心脏标志物检测仪检测心肌肌钙蛋白T(cTnT)水平,采用贝克蔓DXC600检测仪检测Lp(a)水平。依据cTnT术后值,分为正常组(cTnT<0.014μg/L,32例)与升高组(cTnT>0.014μg/L,48例)。比较两组CRP、Lp(a)水平,同时选择多因素logistic回归分析CRP、Lp(a)水平与心肌损伤的相关性。结果稳定组与不稳定组CRP、Lp(a)水平高于对照组,且不稳定组高于稳定组,差异有统计学意义(P<0.05)。升高组CRP、Lp(a)水平高于正常组,差异有统计学意义(P<0.05)。高水平CRP、Lp(a)是冠心病心绞痛患者PCI围手术期cTnT升高的独立危险因素(OR>1,P<0.05)。结论冠心病心绞痛患者PCI围手术期CRP、Lp(a)水平明显升高,且CRP、Lp(a)水平升高是PCI术后心肌损伤出现的独立危险因素。

Objective To observe the levels of C-reactive protein(CRP)and lipoprotein(a)[Lp(a)]in the percutaneous coronary intervention(PCI)perioperative period in patients with coronary heart disease and angina pectoris and their correlation with myocardial injury.Methods The clinical data of 80 patients with coronary heart disease and angina pectoris diagnosed and treated in Chaozhou Central Hospital in Guangdong Province(“our hospital”for short)from March 2020 to March 2021 were retrospectively analyzed.According to the type of angina pectoris,they were divided into stable group(stable angina pectoris,38 cases),and unstable group(unstable angina,42 cases).In addition,50 healthy people who received physical examination in our hospital during the same period were selected as the control group.The immunoscattering turbidimetric method was used to detect the CRP level,the cardiac marker detector was used to detect the cardiac troponin T(cTnT)level,and the Beckman DXC600 detector was used to detect the Lp(a)level.According to the postoperative value of cTnT,they were divided into normal group(cTnT<0.014μg/L,32 cases)and elevated group(cTnT>0.014μg/L,48 cases),and the levels of CRP and Lp(a)were compared between the two groups.At the same time,multivariate logistic regression was selected to analyze the correlation between CRP,Lp(a)levels and myocardial injury.Results The CRP and Lp(a)levels of the stable group and the unstable group were higher than those of the control group,while the unstable group was higher than the stable group,and the differences were statistically significant(P<0.05).The levels of CRP and Lp(a)in the elevated group were higher than those in the normal group,and the differences were statistically significant(P<0.05).High levels of CRP and Lp(a)were independent risk factors for the increase of cTnT in patients with coronary heart disease and angina pectoris during PCI perioperative period(OR>1,P<0.05).Conclusion The levels of CRP and Lp(a)in patients with coronary heart disease and angina pectoris increased significantly during PCI perioperative period,and the increased levels of CRP and Lp(a)are independent risk factors for myocardial injury after PCI.