血清超敏C反应蛋白水平与冠状动脉慢性完全性闭塞病变的关系研究

Relationship between high sensitivity C-reactive protein and chronic total occlusion of coronary artery

目的 探讨血清超敏C反应蛋白(hs-CRP)水平与冠状动脉慢性完全性闭塞病变(CTO)的关系。方法 选取2017年1月1日至2020年6月30日于西部战区总医院行冠状动脉(冠脉)造影检查诊断为CTO的患者57例作为CTO组,匹配同期行冠脉造影的冠脉狭窄患者104例作为冠心病组;冠脉无病变患者70例作为正常组。收集患者基线数据及hs-CRP水平,利用多因素Logistic回归分析和受试者工作特征(ROC)曲线分析hs-CRP水平与CTO的关系。结果 与正常组及冠心病组比较,CTO组有较高的hs-CRP、糖化血红蛋白(HbA1c)、较低的HDL-C及较高的空腹血糖水平,吸烟史、糖尿病史患者所占比例较高(P<0.05)。多元Logistic回归分析显示,hs-CRP是CTO形成的独立危险因素(OR=1.344,95%CI:1.178~1.534,P<0.001)。ROC曲线显示,hs-CRP截点值为3.355 mg/L时,其预测CTO的灵敏度为0.404,特异度为0.891 (AUC=0.671,95%CI:0.584~0.758,P<0.001)。结论 hs-CRP升高是CTO形成的独立危险因素,对预测CTO具有一定参考价值。

Objective To discuss the relationship between level of serum high sensitivity C-reactive protein(hs-CRP)and chronic total occlusion(CTO)of coronary artery.Methods The patients with CTO diagnosed by coronary angiography(CAG)were chosen into CTO group(n=57),patients with coronary artery stenosis diagnosed by CAG were chosen into coronary heart disease group(CHD group,n=104),and patients without coronary artery lesions were chosen into normal group(n=70)from General Hospital of Chinese PLS Western Theater Command from Jan.1,2017 to June 30,2020.The baseline data was collected and hs-CRP level was observed in all groups.The relationship between hs-CRP level and CTO was analyzed by using multi-factor Logistic regression analysis and ROC curve analysis.Results The levels of hs-CRP,glycated hemoglobin(HbAlc),high-density lipoprotein-cholesterol(HDL-C)and fasting plasma glucose(FPG)were higher,and percentages of patients with smoking history and diabetes history were higher in CTO group than those in normal group and CHD group(all P<0.05).The multi-factor Logistic regression analysis showed that hs-CRP was an independent risk factor of CTO occurrence(OR=1.344,95%CI:1.178~1.534,P<0.001).The results of ROC curve analysis showed that the cutoff value of hs-CRP was 3.355 mg/L,in prediction of CTO with hs-CRP,its sensitivity was 0.404 and specificity was 0.891(AUC=0.671,95%CI:0.584~0.758,P<0.001).Conclusion The increase of hs-CRP is an independent risk factor of CTO occurrence,and it has some reference value in CTO prediction.