摘要
目的观察高敏C反应蛋白(hsCRP)对急性ST段抬高型心肌梗死患者近期预后的预测价值。方法选取60例急性ST段抬高型心肌梗死患者作为研究对象,测定患者hsCRP水平,观察患者的心功能指标、心肌损伤标志物,绘制ROC曲线图,计算其敏感性、特异性、阳/阴性预测值和准确性。记录心血管事件的发生率,按照有无心血管事件分为事件组和非事件组。结果事件组中患者的年龄、hsCRP以及糖尿病水平较非事件组高,但男性、LVEF、吸烟则较非事件组低(P<0.05);LVEF、hsCRP存在预测价值,ROC曲线结果表明其最佳阀值为12 mg/L,预测心血管事件的特异性为85.44%、敏感性为47.37%、阴性预测值为74.38%、阳性预测值为56.37%、准确性为72.47%。单因素分析结果提示,吸烟、年龄、糖尿病、hsCRP、LVEF与预后有相关。结论 hsCRP能够有效预测急性ST段抬高型心肌梗死患者近期情况,尤其是心绞痛、心律失常、心源性休克的发生。
Objective To observe the predictive value of high sensitivity C reactive protein （hsCRP） for short term prognosis of patients with acute ST segment elevation myocardial infarction. Methods 60 patients with acute ST segment elevation myocardial infarction were selected as research subject. The hsCRP levels were detected, and the heart functional indexes and myocardial injury markers were observed and recorded. The ROC curve chart were drawn, and its sensitivity, specificity, positive and negative predictive value and accuracy were calculated. The incidences of cardiovascular events were recorded. All cases were divided into event group and non event group according to the occurrence of cardiovascular events. Results The age, hsCRP and diabetes levels of patients in the event group were significantly higher than those in the non event group, but the men, LVEF, smoking were lower than those in the non event group （all P〈0.05）. The LVEF, hsCRP had predictive value, and the ROC curve results showed that the optimal threshold was 12 mg/L, the specificity to forecast cardiovascular events was 85.44%, the sensitivity was 47.37%, the negative predictive value was 74.38%, the positive predictive value was 56.37%, and accuracy was 72.47%. Univariate analysis showed that smoking, age, diabetes, LVEF, and hsCRP level were associated with the prognosis. Conclusions The high sensitivity C reactive protein can effectively predict the recent situation of patients with acute ST segment elevation myocardial infarction, especially the incidences of angina pectoris, arrhythmia and cardiac shock.
作者
卢森荣
LU Senrong(Department of Emergency, Shantou Central Hospital / Affiliated Shantou Hospital of Sun Yet-Sen University, Shantou 515031, China)
出处
《临床医学工程》
2016年第12期1643-1644,共2页
Clinical Medicine & Engineering
关键词
高敏C反应蛋白
ST段抬高
心肌梗死
预后
High sensitivity C reactive protein
ST segment elevation
Myocardial infarction
Prognosis
