非ST段抬高型急性冠脉综合征患者血清胱抑素C水平与GRACE评分的关系

目的：探讨非ST段抬高型急性冠脉综合征（NSTE—ACS）血浆胱抑素（Cys）C水平与全球急性冠状动脉事件注册（GRACE）评分的关系。方法：入选符合标准的NSTE—ACS患者155例，分为非ST段抬高型心肌梗死（NSTEA—MI）组和不稳定型心绞痛（UAP）组，入院后进行GRACE评分，同时第2天清晨空腹采集肘静脉血检测CysC，与87例非冠心病患者进行对照比较。结果：NSTE—ACS患者CysC、GRACE评分与非冠心病组比较均出现显著性升高（P〈0．05），而且血清CysC水平随GRACE危险程度增加而显著升高（P〈0．05），两者呈显著正相关（r=0．55，P〈0．01）。结论：NSTE-ACS患者CysC水平与GRACE评分密切相关。

Relationship between patients with non-ST serum cystatin C level segment elevation acute and GRACE risk score in coronary syndrome

AIM ： To evaluate the relationship between serum cystatin C （CysC） level and the global reg- istry of acute coronary events （GRACE） score in patients with non-ST segment elevation acute coronary syndrome （NSTE-ACS）. METHODS ： One hundred and fifty-five patients with NSTE-ACS were divided into non-ST segment elevation myocardial infarction （NSTEAMI） group and unstable angina pectoris （UAP） group and 87 patients without coronary heart disease （CHD） severed as control group. The GRACE score and CysC were measured and compared. RESULTS： In patients with NSTE-ACS, the level of serum CysC and the GRACE score significantly increased compared with those in control group. With the increase of GRACE risk score, the level of serum CysC significantly increased （ P 〈 0. 05 ）. The correlation analysis showed that GRACE scores had a positive correlation with serum CysC levels （r = 0. 549, P 〈0. 01 ） and multivariate analysis demonstrated that age, creatinine and HDL were the main factors influencing the level of serum CysC. ROC curves analysis showed that the optimal cut-off point of CysC was 1. 185 mg/L and the area under curve （AUC） was the highest （0. 841 ）, with a sensitivity of 69.7% and specificity of 89.3%. CONCLUSION： The level of CysC is closely related to CHD, which could be used as a better indicator of coronary atherosclerosis. Monitoring the dynamic changes helps to predict the occurrence and development of CHD. The higher the levels of CysC, the higher the GRACE scores in NSTE-ACS patients. Measurement of serum CysC level has an important clinical value for early risk stratification, prognosis and treatment options.