血清hs-CRP及红细胞分布宽度与急性冠脉综合征患者危险分层及预后的相关性研究

目的:探讨血清超敏C反应蛋白(hs-CRP)及红细胞分布宽度(RDW)与急性冠脉综合征(ACS)患者危险分层及预后的相关性。方法:将132例ACS患者按照全球急性冠状动脉事件注册(GRACE)危险评分分为低、中、高危三组;检测各组的血清hs-CRP、RDW、肌钙蛋白I(c Tn I)、B型脑钠肽(BNP)水平;并记录入院后心脏超声检查中左室射血分数(LEVF)及住院期间有无发生主要不良心脏时间(MACE)等情况。结果:低、中、高危三组间血清hs-CRP、RDW、BNP、c Tn I、LEVF比较具有统计学差异(P0.05),高危组患者血清hs-CRP、RDW、BNP、c Tn I高于低危组及中危组(P0.05),中危组高于低危组(P0.05);血清hs-CRP水平与GRACE评分呈正相关(rs=0.490,P0.05),RDW水平与GRACE评分亦呈正相关(rs=0.401,P0.05);与非MECE组比较,MECE组患者hs-CRP、RDW较高(P0.05);血清高水平hs-CRP及RDW是ACS患者发生近期住院MACE相关高危因素。结论:血清hs-CRP及RDW水平随着ACS患者危险分层的增加而增加,高水平hs-CRP及RDW是近期发生MACE的高危因素,对临床评估ACS患者病情及预后具有重要价值。

Correlation of Serumhs-CRP and Red Blood Cell Distribution Width with Risk Stratification and Prognosis of Patients with Acute Coronary Syndrome

Objective:To investigate the association of serum hypersensitive c-reactive protein (hs-CRP) and red blood cell distribution width (RDW) with risk stratification and prognosis of patients with acute coronary syndrome (ACS).Methods:132 patients with ACS were divided into low, medium and high risk groups according to the global registered acute coronary events (GRACE) risk score. Serumhs-CRP, RDW, troponinI (cTnI), B-type brain natriuretic peptide (BNP) were detected; left ventricular ejection fraction (LEVF) and major adverse cardiac time (MACE) in hospitalization were recoded.Results:There were statistical differences in hs-CRP, RDW, BNP, cTnI, LEVF between low, moderate and high risk groups (P<0.05). The levels of hs-CRP, RDW, BNP, cTnI in high-risk group were higher than in moderate-risk group and low-risk group (P<0.05), and those in moderate risk group were higher than in low-risk group (P<0.05). Spearsman rank correlation analysis showed that the serum hs-CRP level was positively correlated with GRACE score (rs=0.490, P<0.05), and RDW level was also positively correlated with GRACE score (rs=0.401, P<0.05). The levels of hs-CRP and RDWof MECE group were higher than those of non-MECE group (P<0.05). Multivariable logistic regression analysis showed that high levels of serum hs-CRP and RDWin patients with ACS were MACE-related risk factors for recent hospitalization.Conclusion:Serum hs-RDWand hs-CRP levels increased with the increasing of risk stratification in ACS patients, high levels of hs-CRP and RDWare high risk factors of recent MACE, and has an important value in clinical evaluation on condition and prognosis in patients with ACS.