急性冠脉综合征病人sTREM-1和hs-CRP水平与冠脉血管病变程度及短期临床预后相关性

范新俊; 赵胜; 戎李; 高彦琳; 孙志勇; 李天宇; 成威

doi:10.13898/j.cnki.issn.1000-2200.2024.05.006

急性冠脉综合征病人sTREM-1和hs-CRP水平与冠脉血管病变程度及短期临床预后相关性

Study on the correlation of the serum levels of sTREM-1 and hs-CRP with degree of coronary vascular disease and short-term clinical prognosis in patients with acute coronary syndrome

摘要

摘要:
目的观察血清髓系细胞触发受体1(sTREM-1)和超敏C反应蛋白(hs-CRP)与冠脉血管病变程度及临床预后的相关性。
方法入选200例行冠状动脉造影病人，根据病史、相关检查及冠脉造影结果分为不稳定型心绞痛组(UAP组，共135例)、急性心肌梗死组(AMI组，25例)和非冠心病组(对照组，共40例)。检测病人血清sTREM-1和hs-CRP水平，并对所有病人进行平均6个月的随访，评估2组病人主要心脏不良事件(MACE)的发生情况。
结果 AMI组、UAP组病人血清sTREM-1和hs-CRP水平高于对照组(P＜0.05)，在三支和重度病变组(Gensini评分>48分)中血清sTREM-1和hs-CRP高于单双支及轻中度病变组(P＜0.05)。随访平均6个月后发现MACE组病人血清sTREM-1和hs-CRP水平高于非MACE组(P＜0.05)；二元logstic回归分析显示，hs-CRP、sTREM-1和Gensini评分为ACS病人MACE事件的危险因素(P＜0.05)。ROC曲线结果示血清sTREM-1和血清hs-CRP预测ACS病人MACE事件发生风险的最佳截断值分别为0.33 mg/L和6.30 mg/L，且两者联合可提升诊断的特异度(P＜0.05)。
结论 ACS病人具有较高的血清sTREM-1和hs-CRP水平；ACS病人血清sTREM-1和hs-CRP水平与冠脉血管病变支数和病变严重程度呈正相关关系；血清sTREM-1和hs-CRP与ACS病人MACE呈正相关关系且两者联合诊断可提升MACE事件预测的特异度。

Abstract:
Objective To investigate the correlation of the serum levels of myeloid cell trigger receptor 1(sTREM-1) and hypersensitive C-reactive protein(hs-CRP) with degree of coronary vascular disease and clinical prognosis.
Methods Two hundred patients with coronary angiography were selected, and divided into the unstable angina group(UAP group, 135 cases), acute myocardial infarction group (AMI group, 25 cases) and non-coronary heart disease group(control group, 40 cases) according to their medical history, related examinations and coronary angiography results.The serum levels of sTREM-1 and hs-CRP in all cases were measured, and all patients were followed up for a mean of 6 months to assess the occurrence of major adverse cardiac events(MACE).
Results The serum levels of sTREM-1 and hs-CRP levels in the AMI group and UAP group were significantly higher than those in control group(P < 0.05), and the serum sTREM-1 and hs-CRP levels in triple branches and severe groups(Gensini score >48 points) were significantly higher than those in single, double branches and mild, moderate disease groups(P < 0.05).The serum sTREM-1 and hs-CRP levels in MACE group were higher than those in non-MACE group after 6 months of follow-up(P < 0.05).The results of binary logistic regression analysis showed that the hs-CRP, sTREM-1 and Gensini score were the risk factors of MACE events in ACS patients(P < 0.05).The results of ROC curve showed that the optimal cut-off values of serum sTREM-1 and hs-CRP in predicting the risk of MACE events in ACS patients were 0.33 mg/L and 6.30 mg/L, respectively, and the combination of sTREM-1 and hs-CRP could improve the diagnostic specificity(P < 0.05).
Conclusions Patients with ACS have higher serum sTREM-1 and hs-CRP levels.The serum levels of sTREM-1 and hs-CRP in ACS patients are positively correlated with the number and severity of coronary artery lesions.The serum levels of sTREM-1 and hs-CRP are positively correlated with MACE in ACS patients, and the combination of sTREM-1 and hs-CRP can improve the specificity of MACE event prediction.

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