CAJ | 학술논문

目的：探讨联合检测糖化血红蛋白（HbA1c）和hs-CRP对于急性冠状动脉综合征患者预后的预测价值。方法选取该院2009年8月至2011年8月收治的141例急性冠状动脉综合征患者。根据患者血中 HbA1c和hs-CRP水平，将研究对象分为以下4组：高 HbA1c高hs-CRP组，高HbA1c组，高hs-CRP组，低 HbA1c低hs-CRP组（对照组）。随访至2012年8月，收集患者的临床资料并进行统计分析。结果与对照组相比，高 HbA1c组患者在2年内、其他两组患者在整个随访时间内的累积生存率都有明显的下降（P＜0．05）。将 HbA1c和hs-CRP作为协变量，对患者的生存时间进行Cox回归分析，得出回归方程为h （t ，x）＝h0（t） exp（0．092× HbA1c＋0．610× hs-CRP）。上述方程经拟合优度检验，在α＝0．05水平下，χ2＝10．326，P＜0．01。HbA1c和hs-CRP的 RR值分别为1．971，95％ CI（1．245～2．539），P＜0．05和3．398，95％ CI（2．879～3．917），P＜0．05。该回归模型的灵敏度为75．4％，特异度为83．3％，Kappa值为0．446。结论联合检测 HbA1c和hs-CRP对于急性冠状动脉综合征患者的预后具有中等程度的预测价值。
목적：탐토연합검측당화혈홍단백（HbA1c）화hs-CRP대우급성관상동맥종합정환자예후적예측개치。방법선취해원2009년8월지2011년8월수치적141례급성관상동맥종합정환자。근거환자혈중 HbA1c화hs-CRP수평，장연구대상분위이하4조：고 HbA1c고hs-CRP조，고HbA1c조，고hs-CRP조，저 HbA1c저hs-CRP조（대조조）。수방지2012년8월，수집환자적림상자료병진행통계분석。결과여대조조상비，고 HbA1c조환자재2년내、기타량조환자재정개수방시간내적루적생존솔도유명현적하강（P＜0．05）。장 HbA1c화hs-CRP작위협변량，대환자적생존시간진행Cox회귀분석，득출회귀방정위h （t ，x）＝h0（t） exp（0．092× HbA1c＋0．610× hs-CRP）。상술방정경의합우도검험，재α＝0．05수평하，χ2＝10．326，P＜0．01。HbA1c화hs-CRP적 RR치분별위1．971，95％ CI（1．245～2．539），P＜0．05화3．398，95％ CI（2．879～3．917），P＜0．05。해회귀모형적령민도위75．4％，특이도위83．3％，Kappa치위0．446。결론연합검측 HbA1c화hs-CRP대우급성관상동맥종합정환자적예후구유중등정도적예측개치。
Objective To investigate the prognostic value of HbA1c and hs-CRP in patients with acute coronary syndrome . Methods A total of 141 patients diagnosed as acute coronary syndrome from August 2009 to August 2011 in this hospital were col-lected .According to the levels of HbA1c and hs-CRP ,patients were divided into the following four groups :the high HbA1c and hs-CRP group ,the high HbA1c group ,the high hs-CRP group ,the low HbA1c and hs-CRP group(control group) .After receiving standard treatment and being discharged from hospital ,all patients were followed up every two month until death or the end of the study .Clinical data from all patients were statistically analyzed .Results Compared with the control group ,the cumulative survival of the high HbA1c group was much lower in 2 years(P<0 .05) and the difference between the two groups was not significant 2 years later(P>0 .05) .However ,the cumulative survival in high HbA1c and high hs-CRP group and the high hs-CRP group were significantly lower than the control group through the whole follow-up time .A Cox regression modal with HbA1c and hs-CRP as the covariates established and the formula was :h(t ,x)=h0(t) exp(0 .092 × HbA1c+ 0 .610 × hs-CRP)(χ2 =10 .326 ,P<0 .01) . The value of HbA1c and hs-CRP were associated with increased risk of mortality [RR 1 .971 ,95% CI(1 .245 -2 .539) ,P<0 .05 and RR 3 .398 ,95% CI(2 .879-3 .917) ,P<0 .05 ,respectively] .The specificity and sensitivity of that modal was 75% and 83 .6% , respectively .The Kappa value was 0 .446 .Conclusion The combined detection of HbA1c and hs-CRP level can predict the progno-sis of patients with acute coronary syndromes .