目的 分析冠心病患者PCI前后cTn-T、sCD40L、hs-CRP水平与预后的相关性.方法 将本院行PCI术的192例患者根据术后12个月是否发生并发症及不良心脏事件分为预后良好组(n=156)和预后不良组(n=36),比较2组cTn-T、sCD40L、hs-CRP水平.建立ROC曲线分析血清cTn-T、sCD40L、hs-CRP水平对CAD的预测价值.结果 2组术后24 h cTn-T、sCD40L、hs-CRP水平均高于术前、术后10 min,差异有统计学意义(P＜0.05).术后24 h预后不良组cTn-T、sCD40L、hs-CRP水平均高于预后良好组,差异有统计学意义(P＜0.05).cTn-T、sCD40L、hs-CRP预测PCI术后并发症及MACE的最佳截断值为0.36mg/L、4.11mg/mL、8.28mg/mL,敏感度分别为55.26％、73.29％、81.28％,特异度分别为76.29％、51.42％、69.37％.三个指标联合检测的敏感度和特异度分别为84.29％、78.33％,高于单一指标.结论 PCI可在一定程度上激活CAD患者血管局部及全身的炎症反应,导致心肌损伤,引发并发症及MACE.cTn-T、sCD40L、hs-CRP可作为评价CAD患者PCI预后的辅助指标.
Correlation between cTn-T,sCD40L,hs-CR and prognosis in patients with coronary heart disease before and after PCI
Objective To analyze the correlation between the levels of cTn-T,sCD40L,hs-CRP and prognosis in patients with coronary heart disease before and after PCI.Methods 192 patients who underwent PCI in our hospital were divided into good prognosis group(n=156)and poor prognosis group(n=36)according to whether complications and adverse cardiac events occurred 12 months after the operation.The cTn-T,sCD40L,and hs-CRPcTn level of the two groups were compared.ROC curve was established to analyze the predictive value of serum cTn-T,sCD40L and hs-CRP level for CAD.Results The levels of cTn-T,sCD40L and hs-CRP at 24 hours after operation in the two groups were higher than those before operation and 10 minutes after operation,and the difference was statistically significant(P＜0.05).The levels of cTn-T,sCD40L and hs-CRP in the poor prognosis group at 24 hours after operation were higher than those in the good prognosis group,and the difference was statistically significant(P＜0.05).The optimal cut-off values of cTn-T,sCD40L and hs-CRP for predicting postoperative complications and MACE after PCI were 0.36 mg/L,4.11 mg/mL and 8.28 mg/mL,with sensitivities of 55.26％,73.29％and 81.28％,respectively,the specificities was 76.29％,51.42％and 69.37％,respectively.The sensitivity and specificity of the combined detection of the three indicators was 84.29％and 78.33％,respectively,which were higher than those of a single indicator.Conclusions PCI can activate the local and systemic inflammatory response of the blood vessels in CAD patients to a certain extent,leading to myocardial injury,complications and MACE.cTn-T,sCD40L and hs-CRP can be used as auxiliary indicators to evaluate the prognosis of CAD patients with PCI.
万方数据
维普
