【摘要】 目的:评价高敏C反应蛋白(high-sensitivity C reaction protein,hs-CRP)预测冠状动脉痉挛预后的价值。方法:检测120例明确冠状动脉痉挛患者入院时血浆hs-CRP浓度,经治疗出院后进行电话/门诊随访6个月了解胸痛再发情况,对临床诸因素进行Logistic回归分析,研究冠状动脉痉挛再发的危险因素。建立ROC曲线,评价血浆hs-CRP判断冠状动脉痉挛预后的价值。结果:120例患者中再发胸痛36例,再发胸痛组hs-CRP浓度显著高于非胸痛再发组[中位数为5.4(4.6,7.5)mg/L比4.6(3.6,6.4)mg/L,P<0.05]。各临床因素进行Logistic回归分析,提示hs-CRP(OR=1.55,95%CI:1.02～1.35,P=0.03)和吸烟(OR=1.26,95%CI:1.12.～1.65,P=0.02)是冠状动脉痉挛复发的危险因素。入院hs-CRP在判断预后的ROC曲线下,面积为(0.83,95%CI:0.812～0.819,P<0.05),并将切点值定为1.6mg/L,此值预测胸痛再发敏感性和特异性分别为89%和81%。结论:hs-CRP增高和吸烟是冠状动脉痉挛胸痛再发的危险因素,以1.6mg/L为切点其预测预后的敏感性、特异性分别为89%和81%。更多还原

【Abstract】 Objective: To evaluate the high-sensitivity C-reactive protein in predicting the prognosis in the hospitalized coronary artery spasm patients.Methods: A total of 120 confirmed coronary artery spasm patients were enrolled in the study.During hospitalization,plasma hs-CRP concentrations were measured.ROC analysis was performed to evaluate the prognostic value and logistic regress analyses were used to evaluate if hs-CRP were an independent predictor for recurrent chest pain.Results: During 6 months follow-up,36 patients suffered from recurrent chest pain and the remaining had no symptoms.The plasma hs-CRP concentrations in recurrent chest pain group were significantly higher than those of the remaining.[5.4(4.6,7.5) mg/L vs.4.6(3.6,6.4) mg/L,P<0.05].Area under receiver operating characteristic curve(AUC) to predict the prognosis was 0.83(95%CI: 0.812-0.819,P <0.05).the optimal plasma has-CRP cut-off point for predicting the chest-pain reattack was 1.6mg/L,with a sensitivity 89% and specificity 81% and logistic analyses demonstrated that hs-CRP(OR 1.55,95%CI:1.02-1.35,P=0.03)and smoking(OR 1.26,95% CI:1.12.-1.65,P=0.02)were independent predictors for the recurrence of chest pain.Conclusion : C-reactive protein and smoking may be risk factors for recurrence of chest pain during 6 month follow-up after discharge,the cut-off point for predicting recurrent chest pain were1.6 mg/L in this patient cohort.更多还原