摘要
目的探讨血清碱性磷酸酶(ALP)水平与冠心病(CHD)经皮冠状动脉介入治疗(PCI)患者术后氯吡格雷疗效和心血管事件风险的相关性。方法前瞻性选择2019年1月至2020年12月在西安市第三医院和汉中市人民医院收治的149例CHD住院患者作为研究对象,所有患者均于PCI后行氯吡格雷治疗。收集所有患者入院时空腹肘静脉血样本测定ALP水平,根据ALP水平分为高水平组(60例)和低水平组(89例)。采用改良血栓弹力图法评价两组患者的疗效,采用多因素Logistic回归分析影响氯吡格雷疗效的因素。随访1年,记录两组患者的心血管事件发生情况,并通过绘制Kaplan-Meier曲线评价两组患者的心血管事件发生率。结果高水平组患者的高敏C反应蛋白(hs-CRP)、纤维蛋白原(FIB)、ALP水平分别为(3.56±1.01)mg/L、(2.69±0.48)g/L、(142.29±29.23)U/L,明显高于低水平组的(3.05±0.89)mg/L、(2.33±0.51)g/L、(126.25±28.18)U/L,差异均具有统计学意义(P<0.05);高水平组患者的氯吡格雷疗效为68.33%,明显低于低水平组的83.15%,差异具有统计学意义(P<0.05);经多因素Logistic回归分析结果显示,FIB(OR=4.198,95CI%:1.847~9.541)、ALP(OR=1.019,95CI%:1.004~1.034)、hs-CRP(OR=1.820,95CI%:1.151~2.879)水平是CHD患者PCI术后氯吡格雷疗效的独立危险因素(P<0.05);随访1年,失访4例,最终145例获得随访,46例(31.72%)发生心血管不良事件,其中高水平组25例,低水平组21例;经Kaplan-Meier曲线分析显示,高水平组患者的心血管事件发生风险为43.10%,明显高于低水平组的24.14%,差异具有显著统计学意义(P<0.01)。结论血清ALP水平与CHD患者PCI术后氯吡格雷疗效和心血管事件发生风险有关。
Objective To investigate the correlation between serum alkaline phosphatase(ALP)level and postoperative clopidogrels efficacy and cardiovascular event risk in patients with coronary heart disease(CHD)undergoing percutaneous coronary intervention(PCI).Methods A total of 149 patients with CHD treated in the Third Hospital of Xi'an and Hanzhong People's Hospital from January 2019 to December 2020 were prospectively selected as the research subjects,and all of them received clopidogrel treatment after PCI.Fasting cubital venous blood samples were collected from all patients on admission to determine ALP levels,and the patients were divided into high-level group(60 cases)and low-level group(89 cases)according to ALP levels.The efficacy of clopidogrel in the two groups was evaluated by modified thromboelastometry,and multivariate logistic regression analysis was used to analyze the factors affecting the efficacy of clopidogrel.After 1 year of follow-up,the incidence of cardiovascular events was recorded,and the kaplan-Meier curve was drawn to compare the incidence of cardiovascular events between the two groups.Results The levels of high-sensitivity C-reactive protein(hs-CRP),fibrinogen(FIB),and ALP in the high-level group were(3.56±1.01)mg/L,(2.69±0.48)g/L,and(142.29±29.23)U/L,respectively,which were significantly higher than(3.05±0.89)mg/L,(2.33±0.51)g/L,and(126.25±28.18)U/L in the low-level group(P<0.05).The efficacy of clopidogrel in the high-level group was 68.33%,which was significantly lower than 83.15%in the low-level group(P<0.05).Multivariate Logistic regression analysis showed that FIB(OR=4.198,95CI%:1.847-9.541),ALP(OR=1.019,95CI%:1.004-1.034),hs-CRP(OR=1.820,95CI%:1.151-2.879)were independent risk factors for clopidogrel's efficacy after PCI in CHD patients(P<0.05).During the 1-year follow-up,4 cases were lost to follow-up,and 145 cases were finally followed up,of which 46 cases(31.72%)had cardiovascular adverse events,including 25 cases in the high-level group and 21 cases in the low-level group.Kap
作者
袁平年
王琦
YUAN Ping-nian;WANG Qi(Department of Cardiovascular Medicine,the Third Hospital of Xi'an,Affiliated Hospital of Northwest University,Xi'an 710018,Shaanxi,CHINA;The Second of Department of Cardiovascular Medicine,Hanzhong People's Hospital,Hanzhong 723000,Shaanxi,CHINA)
出处
《海南医学》
CAS
2022年第23期3001-3005,共5页
Hainan Medical Journal
关键词
血清碱性磷酸酶
冠心病
经皮冠状动脉介入治疗
氯吡格雷
心血管不良事件
相关性
Serum alkaline phosphatase
Coronary heart disease
Percutaneous coronary intervention
Clopidogrel
Cardiovascular adverse events
Correlation
