【摘要】 背景:以往的研究认为胱抑素C是评价肾功能肾小球滤过率的敏感指标,近年来也发现与心血管疾病的发生有密切关系。目的:分析ST段抬高的急性心肌梗死患者接受急诊直接冠状动脉药物支架置入后的血清胱抑素C质量浓度对心血管事件及靶血管再狭窄的预测价值。方法:连续选择2007-10/2008-10中南大学湘雅二医院心内科收治的于发病后12h内成功实施急诊冠状动脉药物支架置入的急性ST段抬高心肌梗死患者81例,根据血清胱抑素C的质量浓度分为2组,A组>1.00mg/L,B组≤1.00mg/L。收集患者住院期间及其出院后8个月的临床随访资料。分析患者血清CysC质量浓度与主要不良心血管事件及支架内狭窄的关系。结果与结论:平均随访8个月。两组患者在主要临床不良事件中(如死亡、再梗死、脑卒中、血运重建)差异无显著性意义(P>0.05),A组住院期间死亡率高于B组(χ2=2.50,P≈0.08)。两组患者出院后死亡、再梗、脑卒中、血运重建、支架内血栓形成等差异无显著性意义(P>0.05),A组因心力衰竭再住院率高于B组(P<0.05)。A组支架内再狭窄及靶血管新生血管病变发病率高于B组(P<0.05)。提示ST段抬高的急性心肌梗死患者行急诊冠状动脉药物支架置入治疗后,血清胱抑素C质量浓度与靶血管病变及心血管主要不良事件有关,尤其是因充血性心力衰竭再住院率有关。更多还原

【Abstract】 BACKGROUND:Previous studies have shown that cystatin C is a better endogenous marker of glomerular filtration rate,and is closely correlated with cardiovascular disease.OBJECTIVE:To evaluate the prognostic value of cystatin C on cardiovascular events and target vessel lesion restenosis in patients with ST elevated acute myocardial infarction(STEAMI)treated with primary percutaneous coronary intervention.METHODS:From October 2007 to October 2008,a total of 81 patients who underwent percutaneous coronary intervention for ST-segment elevation myocardial infarction < 12 hours from symptom onset were included at the Department of Cardiology,Second Xiangya Hospital,Central South University.According to cystatin C levels,patients were classified into 2 groups:group A > 1.00 mg/L and group B ≤ 1.00 mg/L.The clinical data was collected during hospitalization and all patients were followed up for nearly 8 months.The relationship of cystatin C mass concentration to main adverse cardiovascular events and stent stenosis was analyzed in patients.RESULTS AND CONCLUSION:Mean duration of clinical follow-up was 8 months.There was no significant difference in death,reinfarction,stroke or revascularization between the two groups(P > 0.05).The death rate during hospitalization was higher in the group A than in the group B(χ2=2.50,P≈0.08).There were no significant differences in death,reinfarction,stroke,revascularization and thrombosis in stent in patients of both groups(P > 0.05).A higher incidence of rehospitalization for congestive heart failure was observed in patients of group A than in group B(P < 0.05).The ratio of in-stent restenosis and target vessel new lesion was significantly higher in group A than in group B(P < 0.05).These suggested that cystatin C plasma concentrations may be associated with target vessel lesion and cardiovascular events,mainly rehospitalization for congestive heart failure,after percutaneous coronary intervention in patients with ST-elevation myocardial infarction.更多还原