中国循环杂志
中國循環雜誌
중국순배잡지
Chinese Circulation Journal
2015年
9期
854-858
,共5页
刘运秋%杨晓燕%王丽晔%兰璇%刘晓宇%熊海亮%吴寿岭
劉運鞦%楊曉燕%王麗曄%蘭璇%劉曉宇%熊海亮%吳壽嶺
류운추%양효연%왕려엽%란선%류효우%웅해량%오수령
高敏C反应蛋白%肺栓塞%预测
高敏C反應蛋白%肺栓塞%預測
고민C반응단백%폐전새%예측
High sensitivity C-reactive protein%Pulmonary embolism%Prediction
目的:探讨基线血清高敏C反应蛋白(hs-CRP)水平对肺栓塞的预测价值。方法:本研究采用前瞻性队列研究方法,以参加2006-07至2007-10健康查体的l0l 510名开滦集团职工作为观察队列,符合入选标准者94314例(男75252例,女19062例),按基线hs-CRP水平四分位数分为第一四分位数组(<0.3l mg/L,n=25592)、第二四分位数组0.3l~0.77 mg/L,n=21746)、第三四分位数组(0.78~1.9 mg/L,n=23504)和第四四分位数组(≥2.0 mg/L,n=23472),随访(81.5±4.76)个月,收集肺栓塞的发病信息,用多变量Cox比例风险回归分析基线血清hs-CRP水平对肺栓塞的预测价值。肺栓塞参照2001年中华医学会呼吸病学分会制定的肺栓塞诊断与治疗指南,采用计算机断层摄影肺动脉造影成像法进行诊断。结果:肺栓塞累计总发病率为0.15%,女性高于男性,但差异无统计学意义(P>0.05)。随着基线hs-CRP水平升高,肺栓塞发生率逐渐增高,差异有统计学意义(P<0.05);多变量Cox比例风险回归分析表明,校正年龄、性别、吸烟、体重指数、收缩压、舒张压、甘油三酯、空腹血糖、中性粒细胞、白细胞及心率后,基线hs-CRP最高四分位数组发生肺栓塞的相对危险为最低四分位数组的2.84倍。随着基线hs-CRP水平升高,研究对象的平均年龄、体重指数、收缩压、空腹血糖、中性粒细胞水平逐渐增高,差异均有统计学意义(P均<0.05);舒张压和甘油三酯水平逐渐升高、心率逐渐增快,但这些指标在第三四分位组与第四四分位数组相比差异无统计意义(P均>0.05)。白细胞计数在前三组呈递增趋势,差异有统计学意义,但在第四四分位数组呈下降趋势,与第三四分位数组相比差异无统计学意义(P>0.05)。结论:基线hs-CRP可预测肺栓塞的发病风险,hs-CRP水平较高提示肺栓塞发生风险增加,是肺栓塞的强预测因子。
目的:探討基線血清高敏C反應蛋白(hs-CRP)水平對肺栓塞的預測價值。方法:本研究採用前瞻性隊列研究方法,以參加2006-07至2007-10健康查體的l0l 510名開灤集糰職工作為觀察隊列,符閤入選標準者94314例(男75252例,女19062例),按基線hs-CRP水平四分位數分為第一四分位數組(<0.3l mg/L,n=25592)、第二四分位數組0.3l~0.77 mg/L,n=21746)、第三四分位數組(0.78~1.9 mg/L,n=23504)和第四四分位數組(≥2.0 mg/L,n=23472),隨訪(81.5±4.76)箇月,收集肺栓塞的髮病信息,用多變量Cox比例風險迴歸分析基線血清hs-CRP水平對肺栓塞的預測價值。肺栓塞參照2001年中華醫學會呼吸病學分會製定的肺栓塞診斷與治療指南,採用計算機斷層攝影肺動脈造影成像法進行診斷。結果:肺栓塞纍計總髮病率為0.15%,女性高于男性,但差異無統計學意義(P>0.05)。隨著基線hs-CRP水平升高,肺栓塞髮生率逐漸增高,差異有統計學意義(P<0.05);多變量Cox比例風險迴歸分析錶明,校正年齡、性彆、吸煙、體重指數、收縮壓、舒張壓、甘油三酯、空腹血糖、中性粒細胞、白細胞及心率後,基線hs-CRP最高四分位數組髮生肺栓塞的相對危險為最低四分位數組的2.84倍。隨著基線hs-CRP水平升高,研究對象的平均年齡、體重指數、收縮壓、空腹血糖、中性粒細胞水平逐漸增高,差異均有統計學意義(P均<0.05);舒張壓和甘油三酯水平逐漸升高、心率逐漸增快,但這些指標在第三四分位組與第四四分位數組相比差異無統計意義(P均>0.05)。白細胞計數在前三組呈遞增趨勢,差異有統計學意義,但在第四四分位數組呈下降趨勢,與第三四分位數組相比差異無統計學意義(P>0.05)。結論:基線hs-CRP可預測肺栓塞的髮病風險,hs-CRP水平較高提示肺栓塞髮生風險增加,是肺栓塞的彊預測因子。
목적:탐토기선혈청고민C반응단백(hs-CRP)수평대폐전새적예측개치。방법:본연구채용전첨성대렬연구방법,이삼가2006-07지2007-10건강사체적l0l 510명개란집단직공작위관찰대렬,부합입선표준자94314례(남75252례,녀19062례),안기선hs-CRP수평사분위수분위제일사분위수조(<0.3l mg/L,n=25592)、제이사분위수조0.3l~0.77 mg/L,n=21746)、제삼사분위수조(0.78~1.9 mg/L,n=23504)화제사사분위수조(≥2.0 mg/L,n=23472),수방(81.5±4.76)개월,수집폐전새적발병신식,용다변량Cox비례풍험회귀분석기선혈청hs-CRP수평대폐전새적예측개치。폐전새삼조2001년중화의학회호흡병학분회제정적폐전새진단여치료지남,채용계산궤단층섭영폐동맥조영성상법진행진단。결과:폐전새루계총발병솔위0.15%,녀성고우남성,단차이무통계학의의(P>0.05)。수착기선hs-CRP수평승고,폐전새발생솔축점증고,차이유통계학의의(P<0.05);다변량Cox비례풍험회귀분석표명,교정년령、성별、흡연、체중지수、수축압、서장압、감유삼지、공복혈당、중성립세포、백세포급심솔후,기선hs-CRP최고사분위수조발생폐전새적상대위험위최저사분위수조적2.84배。수착기선hs-CRP수평승고,연구대상적평균년령、체중지수、수축압、공복혈당、중성립세포수평축점증고,차이균유통계학의의(P균<0.05);서장압화감유삼지수평축점승고、심솔축점증쾌,단저사지표재제삼사분위조여제사사분위수조상비차이무통계의의(P균>0.05)。백세포계수재전삼조정체증추세,차이유통계학의의,단재제사사분위수조정하강추세,여제삼사분위수조상비차이무통계학의의(P>0.05)。결론:기선hs-CRP가예측폐전새적발병풍험,hs-CRP수평교고제시폐전새발생풍험증가,시폐전새적강예측인자。
Objective: To evaluate the predictive value for baseline levels of high sensitivity C-reactive protein (hs-CRP) in morbidity of pulmonary embolism (PE). Methods: We conducted a prospective cohort study of 101510 subjects in Kailuan Group by regular physical examination from 2006-07 to 2007-10, and 94314 subjects were enrolled by relevant criteria including 75252 male and 19062 female. The baseline levels of hs-CRP were divided by quartile levels as①hs-CRP<0.3l mg/L,n=25592,②hs-CRP (0.3l-0.77) mg/L,n=21746,③hs-CRP (0.78-1.9) mg/L,n=23504 and④hs-CRP≥2.0 mg/L,n=23472. The subjects were followed-up for (81.5 ± 4.76) months, the morbidity of PE was collected and the predictive value of baseline levels of hs-CRP for PE occurrence was evaluate by multivariable Cox proportional hazard regression analysis. Results: The total PE morbidity was 0.15%, the female subjects were similar with male subjects,P>0.05. As the increased baseline level of hs-CRP, PE occurrence was elevated accordingly,P<0.05. Multivariable Cox proportional hazard regression analysis presented that with adjusted age, gender, smoking, body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), triglyceride (TG), fasting blood glucose (FBG), neutrophile granulocyte (NEU), white blood cells (WBC) and heart rate (HR), the subjects in the highest quartile group had 2.84 times higher risk for PE occurrence than the subjects in the lowest quartile group. With the elevated baseline level of hs-CRP, the subjects’ mean age, BMI, SBP, FBG and NEU levels increased accordingly, allP<0.05; while DBP, TG and HR were similar between quartile③ and quartile④ groups, allP>0.05. WBC counts had the increasing trend in quartile①,②,③ groups and had the decreasing trend in quartile④ group, while it was similar between quartile③ and quartile④ groups,P>0.05. Conclusion: Baseline hs-CRP level may predict the risk of PE morbidity; the increased hs-CRP level could be used as one of the predictors for PE occurrence.