非ST段抬高型急性冠脈綜合征患者C反應(yīng)蛋白、胱抑素C、載脂蛋白A、脂蛋白a與GRACE評(píng)分的相關(guān)研究.pdf

1、徐慧NSTEACS患者CRP、CysC、ApoA、Lp(a)與GRACE評(píng)分的相關(guān)研究三非ST段抬高型急性冠脈綜合征患者C反應(yīng)蛋白、胱抑素C、載脂蛋白A、脂蛋白a與GRACE評(píng)分的相關(guān)研究中文摘要目的：探討非ST段抬高型急性冠脈綜合征(NonSTsegmentelevationacutecoronarysyndrome，NSTE—ACS)患者血漿高敏C反應(yīng)蛋白(highsensitivityCreactiveprotein，hs—CRP

2、)、胱抑素(CystatinC，CysC)、載脂蛋白A(ApolipoproteinA，ApoA)、脂蛋白a(Lipoproteina，Lp(a))的水平與全球急性冠狀動(dòng)脈事件注冊(cè)(theglobalregistryofacutecoronaryevents，GRACE)危險(xiǎn)評(píng)分的關(guān)系。方法：2012年1月至2013年5月入選我院符合標(biāo)準(zhǔn)的NSTEACS患者共155例，分為非ST段抬高型心肌梗死(NonSTsegmentelevatio

3、nmyocardialinfarction，NSTEAMI)組和不穩(wěn)定型心絞痛(unstableangina，UA)組，入院后采集臨床資料，并進(jìn)行GRACE危險(xiǎn)評(píng)分，同時(shí)第二天清晨空腹采集肘靜脈血檢測(cè)hsCRP、CysC、ApoA、Lp(a)水平，與87例非冠心病患者進(jìn)行對(duì)照比較。所有患者經(jīng)抗凝藥物、抗血小板藥物、硝酸酯類(lèi)、13受體阻滯劑類(lèi)、他汀類(lèi)、血管緊張素轉(zhuǎn)換酶抑制劑(ACEI)或血管緊張素受體拮抗劑(ARB)等治療后擇日行冠狀動(dòng)脈

4、造影檢查。根據(jù)GRACE危險(xiǎn)評(píng)分將患者分為3組：I組(低危組)≤99分，II組(中危組)100140分，III組(高危組)140分。結(jié)果：l、NSTEACS患者h(yuǎn)s—CRP、CysC、Lp(a)、GRACE危險(xiǎn)評(píng)分與對(duì)照組比較均出現(xiàn)顯著性升高，ApoA顯著性降低，差異有統(tǒng)計(jì)學(xué)意義(P005)；2、隨著GRACE危險(xiǎn)程度增高，血清hs—CRP、CysC、Lp(a)水平出現(xiàn)顯著性升高，ApoA顯著性降低，差異有統(tǒng)計(jì)學(xué)意義(P005)；3、相

5、關(guān)性分析顯示NSTEACS患者GRACE危險(xiǎn)評(píng)分與hs—CRP、CysC、Lp(a)呈顯著正相關(guān)關(guān)系(r=0424，P001；r=0549，P00l；r=0134，P001)；與ApoA呈顯著負(fù)相關(guān)關(guān)系(r=0167，P001)；多元線(xiàn)性回歸分析，血清胱抑素、hs—CRP水平對(duì)GRACE危險(xiǎn)評(píng)分影響最大。結(jié)論：徐慧NSTEACS患者CRP、CysC、ApoA、Lp(a)與GRACE評(píng)分的相關(guān)研究Relationshipbetweenbl

6、oodC—reactiveprotein，CystatinC，apolipoproteinA，andlipoproteinaandGRACEriskscoreinpatientswithNon—STsegmentelevationacuteObjective：coronarysyndromeAbstractToevaluatetherelationshipbetweenserumhighsensitivityC—reactiveprot

7、ein(hsCRP)，cystatin(CysC)，apolipoproteinA(ApoA)，lipoproteina(Lp(a))andtheglobalregistryofacutecoronaryevents(GRACE)riskscoresinpatientswithnonSTsegmentelevationacutecoronarysyndrome(NSTEACS)Methods：FromJanuary2012toMay20

8、13，atotalof155consecutivehospitalizedpatientswithestablishedfinaldiagnosesofnonSTsegmentelevationACSwereprospectivelyenrolledinthisobservationalstudyThediagnosisofNSTEACSwasestablishedonthebasisofcurrentguidelinesAllthep

9、atientsweredividedintononSTsegmentelevationmyocardialinfarction(NSTEAMI)groupandunstableanginapectoris(UA)groupAlso，87patientswithoutcoronaryheartdiseaseseveredascontrolgroupAfteradmission，baselineclinicalcharacteristics

10、wereprospectivelyrecorded，GRACEriskscoreintheNSTEACSgroupwerecalculatedandserumlevelsofhsCRP，CysC，ApoAandLp(a)weremeasured，allbloodsampleswereobtainedbeforecoronaryangiographywithin24hoursofhospitaladmissionwhichwerecoll

11、ectedfromeachpatientSantecubitalveinAllpatientsreceivedstandardACStherapyincludingaspirivein(aortocoronaryartery)bypassgraftconvertingenzyme(ACE)inhibitors，betablockers，andstatinsasrecommendedbytheguidelinesPatientsweres