2018 年第 7 期 第 13 卷

同型半胱氨酸和C反应蛋白水平与冠状动脉粥样硬化性心脏病患者经皮冠状动脉介入治疗预后的关系研究

Relation between homocysteine, C-reactive protein level and prognosis of percutaneous coronary intervention in patients with coronary atherosclerotic heart disease

作者：曹建东马晓峰邓勇王红

英文作者：

单位：810012西宁，青海省心脑血管病专科医院干部保健科

英文单位：

关键词：冠状动脉疾病；经皮冠状动脉介入；预后；同型半胱氨酸；C反应蛋白

英文关键词：

• 摘要：

• 【摘要】目的    探讨同型半胱氨酸（Hcy）和C反应蛋白（CRP）水平与冠状动脉粥样硬化性心脏病（冠心病）患者经皮冠状动脉介入（PCI）治疗预后的关系。方法    选取2016年10月至2017年10月在青海省心脑血管病专科医院接受PCI治疗的冠心病患者200例，根据Hcy水平将患者分为Hcy正常组（65例）和Hcy升高组（135例），其中Hcy升高组又根据CRP水平分为CRP升高亚组（＞3 mg/L，71例）和CRP正常亚组（≤3 mg/L，64例）。比较各组PCI术后住院期间及随防期间主要不良心血管事件（MACE）发生情况，分析Hcy和CRP与MACE发生风险的相关性。结果    术后住院期间及随访12个月内，Hcy正常组MACE发生率均明显低于Hcy升高组［1.5%（1/65）比10.4%（14/135）、13.8%（9/65）比27.4%（37/135）］，差异均有统计学意义（均P＜0.05）；CRP正常亚组MACE发生率均明显低于CRP升高亚组［4.7%（3/64）比15.5%（11/71）、18.7%（12/64）比35.2%（25/71）］，差异均有统计学意义（均P＜0.05）。单独Hcy水平增高（比值比=4.488,95%置信区间：1.788～12.473，P=0.021）、Hcy和CRP水平同时增高（比值比=12.537,95%置信区间：8.563～31.435，P=0.005）均与冠心病患者PCI术后MACE风险呈正相关。结论    Hcy、CRP检测对评估冠心病患者PCI术后预后有着重要指导意义，有助于采取积极措施干预，改善患者预后。

• 【Abstract】Objective    To investigate the relation between homocysteine(Hcy), C-reactive protein(CRP) level and prognosis of percutaneous coronary intervention in patients with coronary atherosclerotic heart disease（CHD）. Methods    A total of 200 CHD patients undergoing PCI from October 2016 to October 2017 in Qinghai Cardio-Cerebrovascular Disease Hospital were enrolled; they were divided into normal Hcy level group(n=65) and Hcy increasing group(n=135); patients in Hcy increasing group were divided into CRP increasing group（＞3 mg/L, n=71） and normal CRP group（≤3 mg/L, n=64）. Occurrences of major adverse cardiovascular events（MACE） were observed during hospitalization and follow-up period. Relation between Hcy, CRP level and MACE risk was analyzed by logistic regression. Results    During hospitalization and follow-up period, incidence of MACE in Hcy increasing group was significantly lower than that in normal Hcy level group［1.5%（1/65） vs 10.4%（14/135）, 13.8%（9/65）vs 27.4%（37/135）］; incidence of MACE in CRP increasing group was significantly lower than that in normal CRP normal group［4.7%（3/64） vs 15.5%（11/71）, 18.7%（12/64） vs 35.2%（25/71）］(all P＜0.05). Hcy level increasing alone（OR=4.488, 95%CI： 1.788-12.473， P=0.021）, both Hcy and CRP level increasing（OR=12.537, 95%CI： 8.563-31.435， P=0.005） were positively correlated with MACE risk after PCI. Conclusion    Hcy and CRP detection has important guiding significance for evaluating the prognosis of CHD patients after PCI.

  【Key words】Coronary heart disease；Percutaneous coronary intervention；Prognosis；Homocysteine；C-reactive protein