老年急性心肌梗死患者血清降钙素原水平变化与预后的相关性

目的探讨老年急性心肌梗死(AMI)患者血清降钙素原(PCT)水平变化与近期临床预后的关系。方法选择97例老年AMI患者作为病例组,同期体检者80例作为对照组。测定血清PCT和高敏C反应蛋白(hs-CRP)水平,AMI患者根据血清PCT水平分为正常组(<0.5μg/L)23例、轻度升高组(0.5¹.9μg/L)41例和明显升高组(≥2.0μg/L)33例。随访患者30d心源性死亡和主要心血管不良事件(MACE)发生率。结果病例组患者血清PCT、hs-CRP水平明显高于对照组,差异有统计学意义(3.14±1.59)μg/L vs(0.15±0.04)μg/L,(95.21±20.17)mg/L vs(11.32±9.30)mg/L,P<0.01]。与正常组和轻度升高组比较,明显升高组心源性死亡和MACE发生率显著增加(0%和7.3%vs 24.2%,13.0%和22.0%vs 45.5%,P<0.05)。血清PCT与hs-CRP呈正相关(r=0.4721,P=0.032)。血清PCT可预测老年AMI患者30d心源性死亡和MACE发生率(OR=5.011,OR=4.312,P<0.01)。结论老年AMI患者血清PCT水平升高,对预测近期心源性死亡和MACE有一定参考价值。

Relation between serum procalcitonin level and outcome in elderly patients with acute myocardial infarction

Objective To study the relation between serum procalcitonin(PCT)level and shortterm clinical outcome in elderly patients with acute myocardial infarction(AMI).Methods Ninety-seven elderly AMI patients served as an AMI group and 80 subjects undergoing physical examination served as a control group in this study.Their serum PCT and hs-CRP levels were measured.The patients were further divided into normal group with its serum PCT<0.5μg/L(n=23),mild group with its serum PCT 0.5-1.9μg/L(n=41),and severe group with its serum PCT≥2.0μg/L(n=33).The mortality and incidence of major adverse cardiac events(MACE)on day 30 of follow-up were recorded.Results The serum PCT and hs-CRP levels were significantly higher in AMI group than in control group(3.14±1.59μg/Lvs 0.15±0.04μg/L,95.21±20.17mg/L vs 11.32±9.30mg/L,P<0.01).The mortality and incidence of MACE were significantly higher in normal group than in mild group(0% and 7.3% vs 24.2%,13.0% and 22.0% vs45.5%,P<0.05).The serum PCT level was positively related with the serum hs-CRP level(r=0.4721,P=0.032).The serum PCT level could predict the mortality and incidence of MACE on day 30 of follow-up(OR=5.011,4.312,P<0.01).Conclusion The serum PCT level is higher in elderly AMI patients and can predict their short-term(within 30days)outcome and MACE.