血清胱抑素C对急性冠脉综合征患者预后的预测价值研究

目的 探讨血清胱抑素C(Cys-C)对急性冠脉综合征(ACS)患者近期发生主要不良心血管事件(MACE)(包括心源性猝死),严重的室性心律失常(包括持续性室性心动过速和心室颤动),再次发生非致命性的ACS(再次心绞痛、心肌梗死)及因此再次行血运重建术(包括冠脉支架术、冠脉搭桥术),因充血性心力衰竭再次住院的预测价值.方法 纳入195例ACS患者,对195例ACS患者进行随访,随访终点为发生MACE.所有患者均于入院24 h内检测血Cys-C值.按照随访结果将ACS患者分为MACE组和非MACE组.对Cys-C水平与ACS患者的预后的相关性进行分析,并通过多因素预测模型评价各因素对ACS预后的预测价值.结果 MACE组和非MACE组的组间Cys-C值无差异[(1.41±0.46)mg·L-1 vs(1.32±0.41)mg·L-1,P>0.05];分组后发现MACE组的Cys-C高四分位患者比例略高,非MACE组的Cys-C低四分位患者比例略高,但差异无统计学意义;MACE组的中重度肾功能不全比例明显高于非MACE(34.38％vs 15.34％),而轻中度肾功能不全的比例明显低于非MACE组(18.75％vs 42.33％,P<0.01);在对MACE的单因素回归分析中,Cys-C及其亚组与MACE无相关性.结论该研究发现Cys-C和ACS患者发生MACE无明确相关性.

The prognostic predicitive value of Cystatin Cin patients with acute coronary syndrome

Objective To discuss the relationship between Cystatin C (Cys-C) and acute coronary syndrome (ACS),to evaluate the correlation between Cys-C and the onset of ACS,andto assess thepredictive value of Cys-C on the number and the recent major adverse cardiac events ( MACE) in patients with ACS. Methods One hundred and ninety-fivepatients with ACS were included and followed up. The endpoint of the follow-up was the occurrence of MACE. Serum Cys-C of all patientswas tested within the first 24 hours of admis-sion. The patients with ACS were assigned into MACE group and non-MACE group according to the follow-up results. The correlation of the levels of Cys-C and the prognosis of patients with ACS was analyzed. The predictive value of Cys-C and the prognosis of ACSwere e-valuated through the multivariable forecasting model. Results The Cys-C valueshad no difference between MACE group and the non-MACEgroup[(1.41±0.46) mg·L-1vs(1.32±0.41) mg·L-1,P>0.05].TheCys-Cgroupwassubdividedintodifferentquar-tilesaccording to Cys-C levels and different degreesof renal insufficiency according to eGFR value. The proportion of higher quartile of Cys-C value in MACE group was slightly higher,whilethe proportion of lower quartile of Cys-C value in non-MACE group was slightly higher,but there wereno statisticaldifferences. The proportion of moderate-to-severe renal insufficiency in the MACE group was obviously higher than that in the non-MACE group(34. 38％ vs 15. 34％,P<0. 01). The proportion of mild-to-moderate renal insufficiency in non-MACE group was obviously higher than that in the MACE group (42. 33％ vs 18. 75％,P<0. 01). Single variable regression anal-ysis of the MACE showed that there was no correlation of Cys-C group or subgroups with MACE. Conclusions This study found no correlation of Cys-C group or subgroups with MACE.