摘要
目的探讨同型半胱氨酸(Hcy)和C反应蛋白(CRP)水平与冠状动脉粥样硬化性心脏病(冠心病)患者经皮冠状动脉介入(PCI)治疗预后的关系。方法选取2016年10月至2017年10月在青海省心脑血管病专科医院接受PCI治疗的冠心病患者200例,根据Hcy水平将患者分为Hcy正常组(65例)和Hcy升高组(135例),其中Hcy升高组又根据CRP水平分为CRP升高亚组(>3 mg/L,71例)和CRP正常亚组(≤3 mg/L,64例)。比较各组PCI术后住院期间及随防期间主要不良心血管事件(MACE)发生情况,分析Hcy和CRP与MACE发生风险的相关性。结果术后住院期间及随访12个月内,Hcy正常组MACE发生率均明显低于Hcy升高组[1.5%(1/65)比10.4%(14/135)、13.8%(9/65)比27.4%(37/135)],差异均有统计学意义(均P<0.05);CRP正常亚组MACE发生率均明显低于CRP升高亚组[4.7%(3/64)比15.5%(11/71)、18.7%(12/64)比35.2%(25/71)],差异均有统计学意义(均P<0.05)。单独Hcy水平增高(比值比=4.488,95%置信区间:1.788~12.473,P=0.021)、Hcy和CRP水平同时增高(比值比=12.537,95%置信区间:8.563~31.435,P=0.005)均与冠心病患者PCI术后MACE风险呈正相关。结论 Hcy、CRP检测对评估冠心病患者PCI术后预后有着重要指导意义,有助于采取积极措施干预,改善患者预后。
ObjectiveTo investigate the relation between homocysteine（Hcy）, C-reactive protein（CRP） level and prognosis of percutaneous coronary intervention in patients with coronary atherosclerotic heart disease（CHD）. MethodsA total of 200 CHD patients undergoing PCI from October 2016 to October 2017 in Qinghai Cardio-Cerebrovascular Disease Hospital were enrolled; they were divided into normal Hcy level group（n=65） and Hcy increasing group（n=135）; patients in Hcy increasing group were divided into CRP increasing group（〉3 mg/L, n=71） and normal CRP group（≤3 mg/L, n=64）. Occurrences of major adverse cardiovascular events（MACE） were observed during hospitalization and follow-up period. Relation between Hcy, CRP level and MACE risk was analyzed by logistic regression. ResultsDuring hospitalization and follow-up period, incidence of MACE in Hcy increasing group was significantly lower than that in normal Hcy level group[1.5%（1/65） vs 10.4%（14/135）, 13.8%（9/65）vs 27.4%（37/135）]; incidence of MACE in CRP increasing group was significantly lower than that in normal CRP normal group[4.7%（3/64） vs 15.5%（11/71）, 18.7%（12/64） vs 35.2%（25/71）]（all P〈0.05）. Hcy level increasing alone（OR=4.488, 95%CI： 1.788-12.473, P=0.021）, both Hcy and CRP level increasing（OR=12.537, 95%CI： 8.563-31.435, P=0.005） were positively correlated with MACE risk after PCI. ConclusionHcy and CRP detection has important guiding significance for evaluating the prognosis of CHD patients after PCI.
作者
曹建东
马晓峰
邓勇
王红
Cao Jiandong, Ma Xiaofeng, Deng Yong, Wang Hong(Department of Cadre Health, Qinghai Cardio-Cerebrovascular Disease Special Hospital, Xining 810012, Chin)
出处
《中国医药》
2018年第7期973-976,共4页
China Medicine
关键词
冠状动脉疾病
经皮冠状动脉介入
预后
同型半胱氨酸
C反应蛋白
Coronary heart disease
Percutaneous coronary intervention
Prognosis
Homocysteine
C-reactive protein
