血清C反应蛋白和降钙素原对老年人冠心病和预后不良的影响分析

Influence of serum C-reactive protein and procalcitonin on coronary heart disease and poor prognosis in the elderly

摘要:

目的 研究血清C反应蛋白（CRP）和降钙素原（PCT）预测老年冠心病（CHD）的潜力及其对预后的影响。方法 研究回顾性分析180名患有CHD的老年患者（CHD组）和200名无心血管疾病的患者（对照组）。CHD患者在出院后接受12个月的随访。因不良心血管事件再次入院的患者被纳入预后不良组，其余患者被视为预后良好组。比较CHD组和对照组的血清CRP和PCT水平，使用受试者工作特征（ROC）曲线分析CRP和PCT对CHD和CHD预后不良的诊断价值。结果 CHD组血清CRP和PCT水平明显高于对照组。Logistic回归分析显示血清CRP和PCT是CHD的相关因素。CRP、PCT和两者联合诊断CHD的ROC曲线下面积分别为0.858（95%CI：0.822~0.893，P<0.001）、0.762（95%CI：0.713~0.812，P<0.001）、0.922（95%CI：0.894~0.950，P<0.001）。预后不良组的CRP和PCT水平大大高于预后良好组（P<0.05）。CRP、PCT和两者联合诊断CHD患者预后不良的ROC曲线下面积分别为0.750（95%CI：0.703~0.797，P<0.001）、0.651（95%CI：0.597~0.705，P<0.001）、0.859（95%CI：0.823~0.894，P<0.001）。结论 老年CHD患者的血清PCT和CRP水平均异常升高，且较高的水平与较高的CHD风险和不良预后相关。PCT和CRP的测定对指导临床治疗具有重要意义。

Abstract:

Objective To investigate the potential of serum C-reactive protein (CRP) and procalcitonin (PCT) in predicting elderly coronary heart disease (CHD) and their impact on prognosis.Methods This retrospective analysis included 180 elderly patients with coronary heart disease (coronary heart disease group) and 200 patients without cardiovascular disease (control group). Coronary heart disease patients underwent 12 months of follow-up after discharge. Patients who were readmitted due to adverse cardiovascular events were included in the group with poor prognosis, while the remaining patients were considered in the group with good prognosis. Compare the serum CRP and PCT levels between the coronary heart disease group and the control group, and analyze the diagnostic value of CRP and PCT for coronary heart disease and poor prognosis using the receiver operating characteristic (ROC) curve.Results The serum CRP and PCT levels in the coronary heart disease group were significantly higher than those in the control group. Logistic regression analysis showed that serum CRP and PCT are related factors for coronary heart disease. The areas under the ROC curve for CRP, PCT, and their combined diagnosis of coronary heart disease were 0.858 (95% CI: 0.822–0.893, P<0.001), 0.762 (95% CI: 0.713–0.812, P<0.001), and 0.922 (95% CI: 0.894–0.950, P<0.001), respectively. The CRP and PCT levels in the group with poor prognosis were significantly higher than those in the group with good prognosis. The areas under the ROC curve for poor prognosis in patients with coronary heart disease diagnosed by CRP, PCT, and their combination were 0.750 (95% CI: 0.703–0.797, P<0.001), 0.651 (95% CI: 0.597–0.705, P<0.001), and 0.859 (95% CI: 0.823–0.894, P<0.001), respectively.Conclusion The serum PCT and CRP levels in elderly patients with coronary heart disease are abnormally elevated, and higher levels are associated with a higher risk of coronary heart disease and poor prognosis. The determination of PCT and CRP is of great significance for guiding clinical treatment.