老年急性冠脉综合征患者血清淀粉样蛋白A和超敏C反应蛋白水平与冠状动脉病变程度的关系

目的探究老年急性冠脉综合征(ACS)患者血清淀粉样蛋白A(SAA)、超敏C反应蛋白(hs-CRP)水平与冠状动脉病变程度的关系。方法选择2018年1月至2019年10月我院收治的122例老年心肌梗死(AMI)、不稳定心绞痛(UA)患者作为研究对象,另择同期于我院住院治疗的50例稳定心绞痛(SAP)患者及健康查体者分别纳入SAP组及对照组。采用冠状动脉造影检测冠脉病变情况,采用Gensini评分系统进行冠脉评分并将患者分为轻度组及重度组,测定各组受试者血清SAA、hs-CRP水平。结果①AMI组、UA组、SAP组患者血清SAA、hs-CRP水平显著高于对照组,其中AMI水平最高,UA次之(P<0.05)。②ACS患者不同冠脉病变支数患者血清SAA、hs-CRP水平差异有统计学意义(P<0.05),随着病变支数的增加,血清SAA、hs-CRP水平升高(P<0.05)。③ACS患者重度组血清SAA、hs-CRP水平显著高于轻度组,差异有统计学意义(P<0.05);Pearson相关性分析示,血清SAA、hs-CRP水平与Gensini评分呈正相关(r=0.301,r=0.324,P值均<0.05)。④血清SAA、hs-CRP水平诊断冠脉狭窄重度患者的曲线下面积为0.738、0.725,当截点值为8.80 mg/L、6.83 mg/L时,约登指数最大;两者联合诊断曲线下面积为0.809。结论血清SAA、hs-CRP水平可单独或联合用于评估冠脉病变程度,为患者的早期病情评估及治疗提供参考。

Relationship between serum SAA,hs-CRP levels and severity of coronary artery lesions in elderly patients with acute coronary syndrome

Objective To explore the relationship between the levels of serum amyloid protein A(SAA)and high-sensitivity C-reactive protein(hs-CRP)and the severity of coronary artery lesions in elderly patients with acute coronary syndrome(ACS).Methods A total of 122 elderly patients with myocardial infarction(AMI)or unstable angina pectoris(UA)treated in our hospital between January 2018 and October 2019 were selected as research subjects.Fifty patients with stable angina pectoris(SAP)treated in our hospital during the same period and 20 healthy people were selected as SAP group and control group,respectively.Coronary artery lesions were detected by coronary angiography,and the Gensini scoring system was used for coronary scoring and patients were divided into mild group and severe group.Serum SAA and hs-CRP levels in each group were measured.Results①Serum SAA and hs-CRP levels in the AMI group,UA group and SAP group were significantly higher than those in the control group,which was the highest in AMI group,followed by UA group(P<0.05).②In patients with ACS,there were statistically significant differences in serum SAA and hs-CRP levels among patients with different numbers of diseased coronary vessels(P<0.05).As the number of diseased coronary vessels increased,serum SAA and hs-CRP levels increased(P<0.05).③In patients with ACS,serum SAA and hs-CRP levels were significantly higher in the severe group than those in the mild group(P<0.05).Pearson correlation analysis showed that serum SAA and hs-CRP levels were positively correlated with Gensini scores(r=0.301,r=0.324,P<0.05).④The areas under the curve of serum SAA and hs-CRP for diagnosing severe coronary stenosis were 0.738 and 0.725.When the cutoff values were 8.80 mg/L and 6.83 mg/L,Youden index was the largest.The area under the combined diagnosis curve was 0.809.Conclusion Serum SAA and hs-CRP levels are related to the severity of coronary artery lesions in patients with ACS.It can be used alone or in combination to evaluate the degree of coronary artery disease and provide reference for the early assessment and treatment of patients.