急性冠状动脉综合征患者血浆高敏C反应蛋白/白蛋白比值与主动脉内球囊反搏的关系

Relationship between plasma high-sensitivity C-reactive protein/albumin ratio and intra-aortic balloon pump implanted in patients with acute coronary syndrome

目的探讨急性冠状动脉综合征(ACS)患者血浆高敏C反应蛋白/白蛋白(hs-CRP/ALB)比值与是否需要应用主动脉内球囊反搏(IABP)的关系。方法入选2018年1月至2020年8月在首都医科大学附属北京安贞医院住院的ACS患者共1722例,其中院内应用IABP者102例(IABP组),未应用IABP者1620例(非IABP组)。入院后测定血浆hs-CRP及白蛋白浓度,计算hs-CRP/ALB比值。采用受试者工作特征曲线分析B型脑钠肽(BNP)、hs-CRP、hs-CRP/ALB比值对是否应用IABP的预测价值。采用Logistic回归方法分析ACS患者应用IABP的危险因素。结果IABP组hs-CRP/ALB比值高于非IABP组[0.607(0.183,0.951)比0.086(0.025,0.359)],差异有统计学意义(P<0.05)。BNP、hs-CRP、hs-CRP/ALB比值预测是否应用IABP的曲线下面积分别为0.673、0.770、0.774。Logistic回归分析结果显示,收缩压、hs-CRP、hs-CRP/ALB比值是预测ACS患者应用IABP的独立危险因素(均P<0.001)。结论ACS患者hs-CRP/ALB比值越高应用IABP的风险越高,hs-CRP/ALB比值可作为预测ACS患者是否应用IABP的一个有效指标。

Objective To investigate the relationship between plasma high-sensitivity C-reactive protein(hs-CRP)/albumin(ALB)ratio and intra-aortic balloon pump(IABP)implanted in patients with acute coronary syndrome(ACS).Methods From January 2018 to August 2020,1722 patients with ACS admitted to Beijing Anzhen Hospital,Capital Medical University were selected,including 102 patients with IABP implanted in the hospital(IABP group)and 1620 patients without IABP implanted(non IABP group).The plasma levels of hs-CRP and ALB were measured after admission,and the ratio of hs-CRP/ALB was calculated.The receiver operating characteristic curve was used to analyze the predictive value of brain natriuretic peptide(BNP),hs-CRP and hs-CRP/ALB ratio on whether to implant IABP.Logistic regression analysis was used to analyze the risk factors of IABP implanted in patients with ACS.Results The hs-CRP/ALB ratio in IABP group was significantly higher than that in non IABP group[0.607(0.183,0.951)vs 0.086(0.025,0.359)](P<0.05).The areas under the curve of BNP,hs-CRP and hs-CRP/ALB ratio in predicting IABP implanted were 0.673,0.770 and 0.774,respectively.Logistic regression analysis showed that systolic pressure,hs-CRP and hs-CRP/ALB ratio were independent risk factors for IABP implanted in patients with ACS(all P<0.001).Conclusions The risk of IABP implanted increases with higher hs-CRP/ALB ratio in patients with ACS,and hs-CRP/ALB ratio can be used as an effective index to predict whether ACS patients need to implant IABP.