高敏C反应蛋白对冠状动脉造影大致正常急性心肌梗死的预测价值

摘要

Objective To investigate the predictive value of high-sensitive C-reactive protein (hs-CRP) for acute myocardial infarction(AMI) with roughly normal coronary angiography(CAG).Methods From December 1998 to February 2018,clinical data of 56 patients with AMI and roughly normal CAG(normal coronary artery group) admitted to Beijing Anzhen Hospital,Capital Medical University were retrospectively analyzed;110 patients with AMI caused by coronary atherosclerotic heart disease(stenosis ＞70％) treated by stent implantation were selected as abnormal coronary artery group.General data,laboratory indicators on admission and the predictors of AMI with normal CAG were analyzed.Results Age of patients in normal coronary artery group was lower,smoking rate and hs-CRP level were higher than those in abnormal coronary artery group(all P ＜ 0.05).There were no significant differences of male,hypertension,diabetes,obesity rates and cardiac troponin Ⅰ level between groups(all P ＞0.05).Smoking,age and hs-CRP level were independent predictors of AMI with roughly normal CAG (odds ratio =6.459,0.201,3.397;95％ confidence interval:1.695-23.485,0.069-0.598,1.452-11.637;all P ＜0.05).Conclusion Hs-CRP may be an important factor in predicting the occurrence of AMI with roughly normal CAG findings.%目的 探讨高敏C反应蛋白(hs-CRP)对冠状动脉造影(CAG)大致正常的急性心肌梗死的预测价值.方法 回顾性分析1998年12月至2018年2月首都医科大学附属北京安贞医院收住的CAG大致正常的急性心肌梗死56例患者(冠状动脉正常组)的临床资料,另选取同期住院的冠状动脉造影显示至少1支主要冠状动脉狭窄＞70％并最终置入支架治疗的急性心肌梗死患者110例为冠状动脉异常组.比较2组患者一般资料和入院时实验室指标,分析CAG结果大致正常急性心肌梗死的预测因素.结果 冠状动脉正常组年龄低于冠状动脉异常组,吸烟比例和hs-CRP水平高于冠状动脉异常组,差异均有统计学意义(均P ＜0.05).2组患者男性、高血压、糖尿病、饮酒、肥胖比例和心肌肌钙蛋白Ⅰ水平比较,差异均无统计学意义(均P ＞0.05).吸烟、年龄及hs-CRP水平均为冠状动脉造影大致正常急性心肌梗死的独立预测因素(比值比=6.459、0.201、3.397,95％置信区间:1.695～ 23.485、0.069 ～0.598、1.452～11.637,均P＜0.05).结论 hs-CRP可能是预测CAG大致正常的急性心肌梗死发生的重要因子.