摘要
目的分析炎症因子水平及GRACE评分评估经皮冠脉介入术(PCI)治疗急性心肌梗死(AMI)患者预后的价值。方法回顾性分析2018年8月至2019年10月收治的行急诊PCI治疗的AMI患者200例,其中58例术后1年发生主要不良心血管事件(MACE)(MACE组),142例术后1年未发生MACE(非MACE组)。术前及术后12~24 h内检测患者炎症因子超敏C反应蛋白(hs-CRP)、金属肽酶含血小板反应蛋白基元1(ADAMTS-1)、脂蛋白相关磷脂酶A2(Lp-PLA2)水平及GRACE评分,并进行比较。结果术前两组患者ADAMTS-1、Lp-PLA2水平差异均无统计学意义(P均>0.05),非MACE组患者hs-CRP水平、GRACE评分均低于MACE组患者,且差异均有统计学意义(P均<0.05)。术后两组患者炎症因子水平及GRACE评分均较术前下降,且差异均有统计学意义(P均<0.05);且非MACE组患者炎症因子水平及GRACE评分均低于MACE组患者,差异均有统计学意义(P均<0.05)。术后非MACE组患者较MACE组患者炎症因子(除外hs-CRP)水平及GRACE评分降低程度更为显著(P均<0.05)。Logistic回归分析结果显示,hs-CRP、ADAMTS-1水平及GRACE评分对AMI患者PCI术后发生MACE有预测价值(P均<0.05)。受试者操作特征(ROC)曲线显示,hsCRP、Lp-PLA2、ADAMTS-1水平及GRACE评分对AMI患者PCI术后发生MACE有预测价值,曲线下面积分别为0.970、0.720、0.723、0.831。结论炎症因子水平及GRACE评分评估PCI治疗AMI患者的预后具有一定的应用价值。
Objective To observe different kinds of inflammatory factors level and global registry of acute coronary events(GRACE)score to evaluate the prognosis of acute myocardial infarction(AMI)patients with emergency percutaneous coronary intervention(PCI).Methods Totally 200 AMI patients treatment in First Affiliated Hospital of Hebei North University,the patients all have emergency PCI.12-24 hours after the emergency surgery,all the patients draw blood to determination the hypersensitive C-reactive protein(hs-CRP),adisintegrin and metalloprotease with thrombospongding type 1 motifs(ADAMTS-1),lipoprotein associated phospholipase(Lp-PLA2)level and make the GRACE score,and review the major adverse cardiovascular events(MACE)happened 1 year after the emergency surgery.The patients are divided to Group MACE(58 patients)and Group nMACE(142 patients).Compare the hs-CRP,ADAMTS-1,Lp-PLA2 level and the GRACE score of the two groups.Results Before the emergency PCI,the inflammatory factors such as ADAMTS-1,Lp-PLA2 level of the two groups have no similar difference from each other(P>0.05)and the inflammatory factor hs-CRP and GRACE score nMACE were lower than Group MACE(P<0.05).After emergency PCI,the inflammatory factors level and the GRACE score of the two groups were similar lower than before the emergency PCI(P<0.05).And the Group nMACE were lower than Group MACE(all P<0.05).The inflammatory factors level and the GRACE score of Group nMACE were obviously decreased than Group MACE after emergency PCI,except the hsCRP,the Group MACE was decreased obviously than Group nMACE(all P<0.05).Binary Logistics regression analysis results of MACE after surgery shows the diagnostic value of inflammatory factors(expect Lp-PLA2 level)and the GRACE score in diagnosis MACE(P<0.05).Receiver operator characteristic(ROC)curve of different kinds of inflammatory factors and GRACE score shows,the hs-CRP,ADAMTS-1,Lp-PLA2 level and the GRACE have diagnosis value in MACE(Area under curve,hs-CRP:0.970;ADAMTS-1:0.720;Lp-PLA2:0.723;GRACE score:0.831).Conclusions We can find the diagnostic value of inflammatory factors level and the GRACE score in diagnosis MACE in AMI patients with emergency PCI.
作者
张文婷
白雪琴
李方江
邹芳
要彤
张爱婷
任淑珍
ZHANG Wen-ting;BAIXue-qing;LI Fang-jiang;ZOU Fang;YAO Tong;ZHANG Ai-ting;REN Shu-zhen(Department of Electrocardiogram,First Affiliated Hospital of Hebei North University,Zhangjiakou 075000,Hebei,China;Department of Cardiology,First Affiliated Hospital of Hebei North University,Zhangjiakou 075000,Hebei,China;Department of Respiratory and Intensitive Care Unit,First Affiliated Hospital of Hebei North University,Zhangjiakou 075000,Hebei,China)
出处
《中国分子心脏病学杂志》
CAS
2021年第4期4051-4055,共5页
Molecular Cardiology of China
基金
河北省医学科学研究课题计划(20190912)
张家口市2020年市级科技计划自筹经费项目(2021039D)。
关键词
超敏C反应蛋白
金属肽酶含血小板反应蛋白基元1
脂蛋白相关磷脂酶A2
GRACE评分
经皮冠脉介入术
急性心肌梗死
预后
Hypersensitive C-reactive protein
Adisintegrin and metalloprotease with thrombospongding type 1 motifs
Lipoprotein associated phospholipase
Global registry of acute coronary events score
Percutaneous coronary intervention
Acute myocardial infarction
Prognosis
