CAJ | 학술논문

目的：探讨血清超敏C反应蛋白（hs-CRP）与冠心病PCI手术患者的危险分层、冠状动脉病变严重程度和预后的关系。方法选取150例行 PCI 的冠心病患者，术前行冠状动脉造影并测定 hs-CRP、TG、LDL-C、HDL-C、B 型脑钠肽前体（NT-proBNP）、超敏肌钙蛋白 T（hs-cTnT）水平，根据 hs-CRP 水平将患者分为3组，采用 Gemini 评分判断血管狭窄程度。术后随访6个月，记录主要心血管事件，分析 hs-CRP 与其他冠心病危险因素、Gemini 评分、血管病变支数、MACE 的关系。结果hs-CRP 与HDL-C、hs-cTnT 相关（r 分别为－0．17、0．42，P ＜0．05）。冠心病 PCI 手术患者患者血清 hs-CRP 浓度随着 Gensini 积分的增加而升高，重度血管病变患者的血清 hs-CRP 浓度明显高于轻度血管病变患者和中度血管病变患者（P ＜0．05）。单支、双支和多支病变患者的 hs-CRP 水平分别为（4．64±5．39）、（9．86±8．75）、（14．93±10．34）mg／L，差异有统计学意义（F ＝13．67，P ＜0．05）。hs-CRP 与 Gemini 评分、动脉血管病变数目的相关系数分别为0．21（P ＜0．05）、0．18（P ＜0．05）。三组不同 hs-CRP 水平的患者MACE 发生率比较，差异有统计学意义（χ2＝13．42，P ＝0．001）。hs-CRP 是发生 MACE 的独立危险因素（OR ＝2．05，95％CI ：1．24～3．39，P ＝0．005）。结论hs-CRP 是冠心病患者 PCI 术后心血管事件发生的独立危险因素，与 PCI 患者的血管病变相关，可作为 PCI 术后患者危险分层、病情及预后评估的指标。
목적：탐토혈청초민C반응단백（hs-CRP）여관심병PCI수술환자적위험분층、관상동맥병변엄중정도화예후적관계。방법선취150례행 PCI 적관심병환자，술전행관상동맥조영병측정 hs-CRP、TG、LDL-C、HDL-C、B 형뇌납태전체（NT-proBNP）、초민기개단백 T（hs-cTnT）수평，근거 hs-CRP 수평장환자분위3조，채용 Gemini 평분판단혈관협착정도。술후수방6개월，기록주요심혈관사건，분석 hs-CRP 여기타관심병위험인소、Gemini 평분、혈관병변지수、MACE 적관계。결과hs-CRP 여HDL-C、hs-cTnT 상관（r 분별위－0．17、0．42，P ＜0．05）。관심병 PCI 수술환자환자혈청 hs-CRP 농도수착 Gensini 적분적증가이승고，중도혈관병변환자적혈청 hs-CRP 농도명현고우경도혈관병변환자화중도혈관병변환자（P ＜0．05）。단지、쌍지화다지병변환자적 hs-CRP 수평분별위（4．64±5．39）、（9．86±8．75）、（14．93±10．34）mg／L，차이유통계학의의（F ＝13．67，P ＜0．05）。hs-CRP 여 Gemini 평분、동맥혈관병변수목적상관계수분별위0．21（P ＜0．05）、0．18（P ＜0．05）。삼조불동 hs-CRP 수평적환자MACE 발생솔비교，차이유통계학의의（χ2＝13．42，P ＝0．001）。hs-CRP 시발생 MACE 적독립위험인소（OR ＝2．05，95％CI ：1．24～3．39，P ＝0．005）。결론hs-CRP 시관심병환자 PCI 술후심혈관사건발생적독립위험인소，여 PCI 환자적혈관병변상관，가작위 PCI 술후환자위험분층、병정급예후평고적지표。
Objective To investigate the value of hs-CRP in the assessment of risk stratification,coronary artery disease severity and prognosis for patients undergoing PCI with coronary heart disease.Methods A total of 150 coronary heart disease patients were recruited in the study,who had undergone PCI,and before that all the patients had undergone coronary angiography,and the levels of hs-CRP,TG,LDL-C,HDL-C,NT-proBNP and hs-cTnT were measured.Patients were divided into three groups according to the serum concentration of hs-CRP.Gemini score was used to determine the degree of stenosis.After PCI,patients were followed up for 6 months,the major cardiovascular events(MACE)were recorded.The relationships between hs-CRP and other coronary risk factors,Gemini score,vasculopathy count,MACE events were analyzed.Results The serum concentrations of hs-CRP and HDL-C, hs-cTnT were significantly correlated(r=-0.17,0.42,P <0.05).The level of hs-CRP had increasing tendency with the increase of Gensini score,and the serum concentration of hs-CRP in severe vascular lesions group was significantly higher than both mild vascular lesions group and moderate vascular lesions group(P <0.05).The serum concentration of hs-CRP in single-vessel disease patients,double-vessel disease patients and multi-vessel disease patients were (4.64±5.39),(9.86±8.75),(14.93±10.34)mg/L, there was significant difference among them(P <0.05 ).The correlation coefficients of hs-CRP and Gemini score was 0.21 (P <0.05),while hs-CRP and vasculopathy count was 0.18(P <0.05).The incidence of MACE in three groups were 18.52%,43.75%and 58.66%,which were statistically significantly difference(χ2 =13.42,P =0.001).Logistic regression showed that hs-CRP was an independent risk factor for MACE(OR =2.05,95%CI :1.24 -3.39,P =0.005).Conclusion Hs-CRP is an independent risk factor for coronary heart disease in patients with MACE after PCI,and hs-CRP was correlated with PCI patient′s vascular disease. Hs-CRP can be used as an indicator in the assessment of patient′s condition,PCI risk stratification and prognosis.