血清BGP水平及hs-CRP/PA与老年冠心病患者预后的关系分析

Relationship analysis between serum BGP level and hs-CRP/PA and prognosis in elderly patients with coronary heart disease

目的探讨骨钙素(BGP)水平及超敏C反应蛋白/前清蛋白比值(hs-CRP/PA)与老年冠心病患者预后的关系。方法选择2016年10月至2017年10月该院收治的冠心病患者251例为研究对象,根据冠心病患者在随访期间(随访时间24个月)是否发生心血管不良事件,分为预后不良组和预后良好组,比较2组一般资料及实验室指标。采用多因素Logistic回归模型分析冠心病患者发生心血管不良事件的独立危险因素,采用受试者工作特征(ROC)曲线分析BGP和hs-CRP对发生心血管不良事件的预测效能。结果预后不良组83例,预后良好组168例。预后不良组患者的年龄、糖尿病患者比例、单核细胞计数、红细胞体积分布宽度、hs-CRP/PA及D-二聚体(D-D)水平均高于预后良好组,而BGP水平则明显低于预后良好组,差异均有统计学意义(P<0.05)。多因素Logistic回归模型分析显示,年龄>70岁、有糖尿病史、BGP<24.00 ng/mL、hs-CRP/PA>0.07、D-D>0.49 mg/L是冠心病患者发生心血管不良事件的独立危险因素(OR>1,P<0.05)。ROC曲线分析显示,hs-CRP/PA、BGP预测老年冠心病患者发生心血管不良事件的曲线下面积为0.837、0.841。结论BGP水平降低及hs-CRP/PA升高是老年冠心病患者发生心血管不良事件的独立危险因素,监测其变化对老年冠心病患者病情预测有一定的指导意义。

Objective To investigate the relationship between osteocalcin(BGP)level or high-sensitive C-reactive protein/prealbumin ratio(hs-CRP/PA)and prognosis in elderly patients with coronary heart disease.Methods A total of 251 elderly patients with coronary heart disease admitted to this hospital from October 2016 to October 2017 were selected as the research subjects.According to whether patients with coronary heart disease had cardiovascular adverse events during follow-up(follow-up time of 24 months),they were divided into the poor prognosis group and the good prognosis group,and the general data and laboratory indicators of the two groups were compared.Multivariate Logistic regression model was used to analyze the independent risk factors of cardiovascular adverse events in patients with coronary heart disease,and receiver operating characteristic(ROC)curve was used to analyze the predictive efficacy of BGP and hs-CRP/PA on cardiovascular adverse events.Results There were 83 cases in the poor prognosis group and 168 cases in the good prognosis group.The age,proportion of diabetic patients,monocyte count,red blood cell volume distribution width,hs-CRP/PA and the level of D-dimer(D-D)in the poor prognosis group were higher than those in the good prognosis group,while the level of BGP was significantly lower than that in the good prognosis group,and the differences were statistically significant(P<0.05).Multivariate Logistic regression model analysis showed that age>70 years old,history of diabetes,BGP<24.00 ng/mL,hs-CRP/PA>0.07,D-D>0.49 mg/L were independent risk factors for occurrence of cardiovascular adverse events in patients with coronary heart disease(OR>1,P<0.05).The ROC curve analysis showed that the areas under the curve of hs-CRP/PA and BGP in predicting cardiovascular adverse events in elderly patients with coronary heart disease were 0.837 and 0.841.Conclusion The decrease of BGP level and the increase of hs-CRP/PA are independent risk factors for the occurrence of cardiovascular adverse events in elderly patients with coronary heart disease,and monitoring their changes has certain guiding significance for the prognosis of elderly patients with coronary heart disease.