高敏C反应蛋白水平对预测急性ST段抬高心肌梗死心脏不良事件的临床价值

目的:探讨高敏C反应蛋白(hsCRP)水平对预测急性ST段抬高心肌梗死(STEMI)心脏不良事件的临床价值。方法:选取我院2008年5月至2009年9月收治的240例STEMI的患者为研究对象,入院后测定hsCRP的水平,随访12个月,观察终点为心肌梗死新发或再发、心力衰竭和心源性死亡,采用多元Logistic回归分析方法对各种潜在危险因素与主要不良心脏事件(MACE)的相关性进行分析。结果:年龄>70岁、糖尿病、吸烟、左室射血分数(LVEF)<50%、肌钙蛋白I>0.1μg.L-1、B型钠尿肽>80 ng.L-1、hsCRP>4 mg.L-1都与发生MACE有关(P<0.05)。MACE组的hsCRP水平显著高于非MACE组(P<0.05);hsCRP>4 mg.L-1组的MACE发生率显著高于hsCRP≤4 mg.L-1组(P<0.05);多因素回归分析表明年龄>70岁、糖尿病、LVEF<50%、hsCRP>4 mg.L-1是预测MACE的独立危险因素(P<0.05)。结论:hsCRP是STEMI患者MACE的独立危险预测因子,对患者的近期预后有重要的临床价值。

Predictive value of high sensitivity C-reactive protein for major adverse cardiac event in patients with acute ST-segment elevated myocardial infarction

Objective: To investigate the predictive value of high sensitive C-reactive protein(hsCRP) level for major adverse cardiac event(MACE) in patients with acute ST-segment elevated myocardial infarction(STEMI).Methods: 240 cases of STEMI patients in our hospital from May,2008 to September,2009 were chosen as the research object,determine the levels of hsCRP after admission,and followed up for 12 months,end point of observation was for new-onset or recurrent myocardial infarction,heart failure and cardiac death,using a multivariate Logistic regression analysis method for various potential risk factors and MACE correlation analysis.Results: age>70 years,diabetes,smoking,and left ventricular ejection fraction(LVEF<50%),troponin T>0.1 g·L-1,B type natriuretic peptide >80ng·L-1,hsCRP>4mg·L-1 were relative to MACE(P<0.05).The level of hsCRP in group MACE was significantly higher than that in group no MACE(P<0.05);the incidence of MACE in group hsCRP>4mg·L-1 was significantly higher than that of group hsCRP≤4mg·L-1(P<0.05);multiple regression analysis showed that age >70 years,diabetes,LVEF< 50%,hsCRP>4mg·L-1 were predictor of MACE independent risk factors(P<0.05).Conclusion: hsCRP is independent risk predictor for STEMI patients with MACE,which has important clinical value.