摘要
目的探讨术前C反应蛋白与白蛋白比值对急性心肌梗死患者PCI术中慢血流和无复流的预测价值。方法连续纳入安阳市人民医院胸痛中心于2019年10月至2021年6月因STEMI行急诊PCI的患者200例。根据PCI术中冠状动脉血流TIMI分级分组,TIMI血流0~2级为慢血流/无复流组69例,TIMI血流3级正常血流组131例,所有患者于急诊介入术前抽外周静脉血留取血样测定C反应蛋白,白蛋白,计算C反应蛋白/白蛋白比值,比较两组患者血清C反应蛋白、白蛋白水平、C反应蛋白/白蛋白比值,C反应蛋白参考范围0~4 mg/L,白蛋白水平参考范围40~55g/L。分析上述指标对STEMI急诊PCI术中慢血流/无复流的预测价值。结果慢血流/无复流组PCI术前C反应蛋白和C反应蛋白/白蛋白比值均显著高于正常血流组(P<0.05),而白蛋白水平低于正常血流组(P<0.05);logistic回归分析多因素回归分析显示C反应蛋白、白蛋白水平、C反应蛋白/白蛋白比值对急性心肌梗死PCI术中发生SF/NRF具有预测价值。ROC曲线分析显示,当C反应蛋白/白蛋白比值为0.0309时,对术中发生慢血流/无复流的预测价值较大,曲线下面积为0.724(95%CI 0.622~0.826,P<0.01),预测敏感度为81%,特异度为60.6%。结论术前测定C反应蛋白与白蛋白比值对急性心肌梗死急诊PCI术中发生慢血流/无复流具有较高的预测价值,为临床早期干预提供参考。
Objective To investigate the predictive value of C-reactive protein-albumin ratio(CAR)for slow flow/no-reflow(SF/NRF)during percutaneous coronary intervention(PCI)in patients with acute ST-segment elevation myocardial infarction(STEMI).Methods A total of 200 patients with STEMI who underwent emergency PCI at the Chest Pain Center of Anyang People's Hospital in Henan Province from October 2019 to June 2021.According to the coronary blood flow dru⁃ing PCI.The participants were categorized into two groups:reflow group(n=131)and slow flow/no-reflow(SF/NRF)group(n=69)groups.All participants were draw nvenous blood sample before PCI.Serum albumin,C-reactive protein(CRP)levels and CAR were measured.The CAR was calculated by dividing the serum CRP level by the serum al⁃bumin level.Normal ranges were 0-4 mg/L for CRP,40-55 g/L for albumin.CAR,Serum albumin and CRP levels of the two groups were compared.The influencing factors of SF/NRF and the predictive value of CAR for SF/NRF were analyzed.Results In the SF/NRF group,both CRP and CAR demonstrated significantly higher levels,while the albu⁃min level was lower compared to the reflow group.these factors were identified as independent predictors of SF/NRF development The optimal cutoff value for predicting SF/NRF using CARwas determined to be 0.0309,the area under the curve was 0.724(95%CI 0.622-0.826,P<0.01),achieving a sensitivity of 81%and specific-ity of 60.9%.CAR exhibited superior predictive power compared to both CRP and albumin in the receiver operator curve(ROC)com⁃parison.Conclusion The C-reactive protein-albumin ratio(CAR)holds significant predictive value for the occur⁃rence of slow flow/no-reflow phenomena prior to percutaneous coronary intervention in patients of ST-segment eleva⁃tion myocardial infarction.
作者
可海霞
马小博
马明俊
张海柱
刘志广
杨静静
师宾芬
魏伟丽
杨永全
KE Hai-xia;MA Xiao-bo;MA Ming-jun;ZHANG Hai-zhu;LIU Zhi-guang;YANG Jing-jing;SHI Bin-fen;WEI Wei-li;YANG Yong-quan(Cardiovascular Department of Anyang People’s Hospital,Anyang,Henan 455000,China;Henan University of Science and Technology,Luoyang,Henan 471000,China)
出处
《医药论坛杂志》
2024年第2期161-165,共5页
Journal of Medical Forum
基金
河南省医学科技攻关计划联合共建项目(LHGJ20191271)。
