急性ST段抬高型心肌梗死患者mCRP、GAS与冠脉病变程度的关系

摘要

目的分析急性ST段抬高型心肌梗死(STEMI)患者血浆单体C反应蛋白(mCRP)、心脏整体面积应变(GAS)与冠状动脉(冠脉)病变程度的关系.方法选择2014年1月～2017年6月于武警后勤学院附属医院收治的STEMI患者124例作为研究对象,根据Gensini积分分为轻度病变组(0＜Gensini积分≤40,n=32)、中度病变组(40＜Gensini积分＜80,n=55)和重度病变组(Gensini积分≥80,n=37),另选取同期冠脉造影检查正常者30例作为对照组.对比两组患者的一般临床资料及mCRP、GAS,采用Pearson相关分析分析mCRP、GAS与冠脉病变程度的关系.结果各组性别、平均年龄比较差异无统计学意义(P＞0.05),轻度病变组、中度病变组、重度病变组总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)水平显著高于对照组,高密度脂蛋白胆固醇(HDL-C)水平显著低于对照组(P＜0.05).轻度病变组、中度病变组、重度病变组m CRP、左室射血分数(LVEF)水平显著高于对照组,GAS水平显著低于对照组(P＜0.05).m CRP水平随着病变严重程度增加而增加,GAS水平随着病变严重程度增加而降低,不同冠脉病变程度患者血清m CRP、GAS水平差异均有统计学意义(P＜0.05).Pearson相关性分析显示,mCRP水平与Gensini积分呈正相关(r=0.672,P＜0.05),GAS值与Gensini积分呈负相关(r=-0.562,P＜0.05).结论mCRP水平、GAS值与STEMI病变严重程度密切相关,mCRP水平、GAS值可评价急性ST段抬高型心肌梗死患者冠脉病变严重程度.%Objective To analyze the relationship among monomers C-reactive protein (mCRP), global area strain (GAS) and severity of coronary artery lesions in patients with ST-segment elevation myocardial infarction (STEMI).Methods STEMI patients (n=124) were chosen from Affiliated Hospital of Logistics University of People's Armed Police Force from Jan.2014 to June 2017.The patients were divided, according to Gensini integrals, into mild lesion group (0＜Gensini integrals≤40, n=32), moderate lesion group (40＜Gensini integrals＜80, n=55 and severe lesion group (Gensini integrals≥80, n=37), and other cases with normal results of coronary angiography were chosen into control group (n=30).The general clinical data, mCRP and GAS were compared in all groups, and relationship among mCRP, GAS and severity of coronary artery lesions was analyzed by using Pearson correlation analysis.Results The difference in sex and average age had no statistical significance among all groups (P＞0.05).The levels of TC, TG and LDL-C were significantly higher, and level of HDL-C was significantly lower in mild lesion group, moderate lesion group and severe lesion group than those in control group (P＜0.05).The levels of mCRP and LVEF were significantly higher, and level of GAS was significantly lower in mild lesion group, moderate lesion group and severe lesion group than those in control group (P＜0.05).The level of mCRP increased and level of GAS decreased as severity of coronary artery lesions increased, and difference in levels of mCRP and GAS had statistical significance among mild lesion group, moderate lesion group and severe lesion group (P＜0.05).The results of Pearson correlation analysis showed that mCRP level was positively correlated to Gensini integrals (r=0.672, P＜0.05), and GAS level was negatively correlated to Gensini integrals (r=-0.562, P＜0.05).Conclusion The levels of mCRP and GAS are closely correlated to severity of coronary artery lesions, so they can be used to review the severity of coronary artery lesions in patients with STEMI.