急性冠状动脉综合征患者基线C反应蛋白和低密度脂蛋白水平对其急性期预后的意义

目的分析基线高敏C反应蛋白（hs—CRP）和低密度脂蛋白胆固醇（LDL—C）水平与不同急性冠状动脉综合征（ACS）急性期预后的相关性及意义。方法连续入选172例ACS患者，入院24h内测定患者基线状态的hs—CRP和LDL—C水平，对所有患者随访30d，记录任何原因死亡、心血管事件（事件）发生次数和时间。按出现死亡、事件和无事件对患者进行分组，分析和比较三组患者基线hs—CRP、LDL～C和hs—CRP／LDL—C。应用Logistic回归分析包括年龄，治疗前、后血肌酐（Cr）水平等共19项危险因素对死亡率和事件发生率的影响。结果单因素分析显示，三组ACS患者基线LDL—C水平差异无统计学意义，死亡患者的LDL—C有更低的倾向。死亡患者的hs—CRP是无“事件”患者的13．0倍，是单纯有“事件”患者的5．5倍，差异有统计学意义。结论基线hs—CRP是ACS患者急性期死亡和心血管事件的非独立危险因素，基线LDL—C与急性预后不相关。hs—CRP可作为急性期治疗的靶目标。

The short-time prognostic value of baseline levels of C reactive protein and low density lipoprotein cholesterol to patients with acute coronary syndrome

Objective To investigate the short-time prognostic value of baseline levels of high sensitive C reactive protein（hs-CRP） and low density lipoprotein cholesterol（LDL-C） to patients with acute coronary syndrome （ACS）. Methods The consecutive 172 hospitalized patients with ACS were included in the study. Both baseline levels of hs-CRP and LDL-C of were determined within 24 hours of admission. Patients were followed up for 30 days, all-cause death and cardiovascular events were recorded. Patients were grouped by prognosis of death, cardiovascular event （＂event＂） and no-event respectively, the baseline levels of hsCRP, LDL-C and hsCRP/LDL-C of three groups were compared by One-way ANOVA. The effects of 19 risk factors （age, sex, creatinine level on admission and post-treatment, etc. ） on death and cardiovascular events were analyzed by logistic regression model. Results One-way ANOVA showed that the baseline levels of LDL-C among three groups were not statistic different, and those of death patients had lower trend. The baseline level of hs-CRP of death group patients was thirteen times higher than that of non-event group patients, and five point five times higher than that of event group, it had significantly statistic difference. Conclusion Baseline level of hs-CRP is an independent risk factor of death and cardiovascular events in early stage. Baseline level of LDL-C is not relative to death and cardiovascular events in early stage. The hs-CRP can be a target of treatment in ACS patients in early stage.