摘要
目的:CRP是冠心病患者心血管事件的独立预测因子,而CRP与冠状动脉搭桥术后住院期间不良事件的相关性研究尚未明确。本文目的在于评估术前CRP对冠脉搭桥术后心血管事件的预测价值。方法:入选2008年4月15日到2009年4月4日的66名择期体外循环下冠脉搭桥术患者在术前检测高敏CRP(hs-CRP)水平,观察术后心血管事件包括心因性死亡,缺血性卒中,心肌损伤,心肌梗死和低排量心力衰竭。结果:在术后30天内,14例患者发生心血管不良事件:10例(15%)发生心肌损伤,4例(6%)发生低排量心力衰竭和2例(3%)发生卒中。术前hs-CRP≧3.5mg/l提示有较高的术后心血管不良事件发生率(36%VS6%,P=0.01),心肌损伤(24%VS6%P=0.04),低排量心力衰竭(12%VS0%,P=0.04).应用多元素logistics回归分析显示hs-CRP≧3.5mg/l(P=0.002,OR:19.395%CI2.9-128),手术期间输入红细胞(P=0.04,OR:9.995%CI1.1-85.5),在抗高血压用药日间未采用利尿剂是术后并发心血管事件的独立预测因素(P=0.02,OR:15.195%CI1.4-160.6)。结论:术前hs-CRP≧3.5mg/l的患者在行冠脉搭桥术后发生不良心血管事件显著增加。
Objective： C-reactive protein is a powerful independent predictor of cardiovascular events in patients with coronary, artery disease. The relation between C-reactive protein（CRP） concentration and m-hospital outcome, after coronary artery bypass grafting （CABG）, has not yet been established. This study aims to evaluate the predictive value of preoperative CRP for in-hospital cardivascular events after CABG surgery. Methods： High-sensitivity CRP （hs-CRP） levels were measured pre-operatively on the day of surgery in 66 patients scheduled for elective on pump CABG surgery：. Post-opertive cadiovascular events such as death from cadiovascular causes, ischemic stroke, myocardial damage,myocardial infarction and low output heart failure were recorded, Results： During the first 30 days after surgery, 14 patients developed the following cadiovascular events：10 （15%） had myocardial period. Serum concentration of hs-CRP 3.3mg/I was related to higher risk of post-operative cadiovascular events（ 36%VS6%,P-0.01 ）, myocadial damage（ 24%VS 6% P=0.04 ）, low output heart failure （ 12% VS 0%.P 0.04）. Mutivariate logistic regression analysis showed that hs-CRP ≧ 3.5mg/l （P=0.002,OR： 10.3 95%CI 2.0-128）, intra-operative transfusion of red blood cells （ P=0.04, OR：9.9 95%CI 1.1-85.5 ）,and absence of diuretics in daily antihypertensive treatment were independent predictors of combined cadiovascular event （ P=0.02, OR ： 15.1 95%CI 1.4-160.6 ）. Conclusion： Patients with hs-CRP value greater or equal to 3.5rag I pre-operatively have increased risk of post-operative cardiovascular events after coronary artery bypass grafting surgery.
出处
《现代生物医学进展》
CAS
2009年第18期3461-3463,3460,共4页
Progress in Modern Biomedicine
关键词
C反应蛋白
冠状动脉搭桥术
心血管不良事件
C-reactive protein
Coronary artery bypass grafting
Adverse cardiovascular event
