中华麻醉学杂志
中華痳醉學雜誌
중화마취학잡지
CHINESE JOURNAL OF ANESTHESIOLOGY
2011年
1期
59-62
,共4页
解康杰%孔微微%罗科%黄志莲%张旭彤%李军
解康傑%孔微微%囉科%黃誌蓮%張旭彤%李軍
해강걸%공미미%라과%황지련%장욱동%리군
C反应蛋白质%预测%糖尿病%手术中并发症%心血管疾病
C反應蛋白質%預測%糖尿病%手術中併髮癥%心血管疾病
C반응단백질%예측%당뇨병%수술중병발증%심혈관질병
C-reactive protein%Forecasting%Diabetes mellitus%Intraoperative complications%Cardiovascular diseases
目的 评价高敏C反应蛋白(hs-CRP)预测糖尿病患者围术期心血管事件(CVA)发生的准确性.方法 合并2型糖尿病的择期非心脏手术患者91例,根据血浆hs-CRP浓度分为低浓度组(hs-CRP<1.0 mg/L,n=9)、中浓度组(hs-CRP 1.0~2.9 mg/L,n=16)及高浓度组(ha-CRP 3.0~10.0mg/L,n=66).记录与围术期CVA发生可能有关的术前因素.采用Spearman秩相关分析与围术期CVA发生相关的危险因素,对危险因素进一步纳入logistic回归分析,筛选高度相关的危险因素.采用受试者工作特征(ROC)曲线下面积分析危险因素预测围术期CVA发生的准确性.结果 低浓度组、中浓度组及高浓度组围术期CVA的发生率分别为0、31%和35%.Spearman秩相关分析结果表明,ECG、NYHA分级、年龄、超声心动图、hs-CRP及ASA分级是与围术期CVA发生相关的危险因素(P<0.05或0.01).logistic回归分析结果表明,ECG、NYHA分级和年龄是与围术期CVA发生高度相关的危险因素(P<0.05或0.01).ECG、NYHA分级、年龄、hs-CRP预测围术期发生CVA的ROC曲线下面积分别为0.855、0.755、0.702和0.605.结论 血hs-CRP浓度预测糖尿病患者围术期CVA发生的准确性低于ECG、NYHA分级和年龄.
目的 評價高敏C反應蛋白(hs-CRP)預測糖尿病患者圍術期心血管事件(CVA)髮生的準確性.方法 閤併2型糖尿病的擇期非心髒手術患者91例,根據血漿hs-CRP濃度分為低濃度組(hs-CRP<1.0 mg/L,n=9)、中濃度組(hs-CRP 1.0~2.9 mg/L,n=16)及高濃度組(ha-CRP 3.0~10.0mg/L,n=66).記錄與圍術期CVA髮生可能有關的術前因素.採用Spearman秩相關分析與圍術期CVA髮生相關的危險因素,對危險因素進一步納入logistic迴歸分析,篩選高度相關的危險因素.採用受試者工作特徵(ROC)麯線下麵積分析危險因素預測圍術期CVA髮生的準確性.結果 低濃度組、中濃度組及高濃度組圍術期CVA的髮生率分彆為0、31%和35%.Spearman秩相關分析結果錶明,ECG、NYHA分級、年齡、超聲心動圖、hs-CRP及ASA分級是與圍術期CVA髮生相關的危險因素(P<0.05或0.01).logistic迴歸分析結果錶明,ECG、NYHA分級和年齡是與圍術期CVA髮生高度相關的危險因素(P<0.05或0.01).ECG、NYHA分級、年齡、hs-CRP預測圍術期髮生CVA的ROC麯線下麵積分彆為0.855、0.755、0.702和0.605.結論 血hs-CRP濃度預測糖尿病患者圍術期CVA髮生的準確性低于ECG、NYHA分級和年齡.
목적 평개고민C반응단백(hs-CRP)예측당뇨병환자위술기심혈관사건(CVA)발생적준학성.방법 합병2형당뇨병적택기비심장수술환자91례,근거혈장hs-CRP농도분위저농도조(hs-CRP<1.0 mg/L,n=9)、중농도조(hs-CRP 1.0~2.9 mg/L,n=16)급고농도조(ha-CRP 3.0~10.0mg/L,n=66).기록여위술기CVA발생가능유관적술전인소.채용Spearman질상관분석여위술기CVA발생상관적위험인소,대위험인소진일보납입logistic회귀분석,사선고도상관적위험인소.채용수시자공작특정(ROC)곡선하면적분석위험인소예측위술기CVA발생적준학성.결과 저농도조、중농도조급고농도조위술기CVA적발생솔분별위0、31%화35%.Spearman질상관분석결과표명,ECG、NYHA분급、년령、초성심동도、hs-CRP급ASA분급시여위술기CVA발생상관적위험인소(P<0.05혹0.01).logistic회귀분석결과표명,ECG、NYHA분급화년령시여위술기CVA발생고도상관적위험인소(P<0.05혹0.01).ECG、NYHA분급、년령、hs-CRP예측위술기발생CVA적ROC곡선하면적분별위0.855、0.755、0.702화0.605.결론 혈hs-CRP농도예측당뇨병환자위술기CVA발생적준학성저우ECG、NYHA분급화년령.
Objective To evaluate the accuracy of high-aensitivity C-reactive protein (hs-CRP) in the prediction of perioperative cardiovascular accidents (CVAS) in patients with diabetes mellitus. Methods Ninetyone type 2 diabetic patients undergoing elective non-cardiac surgery were divided into 3 groups according to their blood concentrations of hs-CRP: low-concentration group < 1.0 mg/L ( group Ⅰ , n = 9); median-concentration group 1.0-2.9 mg/L (group Ⅱ ,n= 16) and high-concentration group 3.0-10.0 mg/L (group Ⅲ ,n =66). Risk factors for perioperative CVA were analyzed using Spearman rank correlation analysis. Various risk factors including sex, age, ASA physical status, BMI, NYHA claasification, smoking history ,preoperative ECG changes, duration,treatment and complications of diabetes mellitus, hypertension and blood lipids were correlated with perioperative CVA. The risk factors of which P values were less than 0.05 would enter the binary logistic regression analysis to stratify CVA-related risk factors. Area under the ROC curve was used to analyze the accuracy of the risk factors in prediction of perioperative CVA. Results The incidences of perioperative CVAs were 0, 31% and 35 % in Ⅰ ,Ⅱ and Ⅲ groups respectively. It was determined by Spearman rank correlation analysis that preoperative ECG,NYHA classification, age, preoperative cardiovascular color doppler ultrasound, blood hs-CRP concentration and ASA classification of physical status were important risk factors ( P < 0.05 or 0.01 ). Binary logistic regression .malysis indicated that preoperative ECG, NYHA classification and age were highly related to perioperative CVA (P <0.05 or 0.01).The area under ROC curve of preoperative ECG, NYHA classification, age and blood hsCRP concentration was 0.855, 0.755, 0.702 and 0.605 respectively. Conclusion The accuracy of blood concentration of hs-CRP in prediction of perioperative CVA in patients with diabetes mellitus is lower than that of the preoperative ECG, NYHA classification or age.