外周血嗜酸性粒细胞及hs-CRP与冠脉病变及预后的关系

发布时间：2018-02-09 10:39

本文关键词： 嗜酸性粒细胞 hs-CRP 冠脉病变预后　出处：《山西医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:通过检测冠心病(Coronary artery disease,CHD)患者外周血嗜酸性粒细胞(EOS)计数及超敏C反应蛋白(hs-CRP)水平,探讨外周血EOS计数及hs-CRP水平与冠脉病变及预后的关系。方法:挑选了自2016年5月-2016年10月山大一院心血管内科CCU病区收治的冠心病患者112例作为观察组,同期非冠心病患者66例为正常对照组,测定其入院外周血EOS计数及hs-CRP水平,比较两组外周血EOS计数及hs-CRP的水平;将冠心病患者按照冠脉狭窄程度及病变支数分组,分析外周血EOS计数及hs-CRP水平与冠脉病变程度及支数的关系。再将冠心病患者组分为AMI组、UA组、SAP组,比较各组间外周血EOS计数、hs-CRP水平变化情况。对冠心病组患者随访3个月,记录MACE事件的发生情况。结果:冠心病组中AMI组患者外周血EOS计数水平低于UA组、SAP组及正常对照组,hs-CRP水平明显高于UA组、SAP组及正常对照组(P㩳0.05,表2)。冠脉狭窄重度组EOS计数水平与轻度狭窄组相比有统计学差异(P㩳0.05,表3)。冠脉病变重度及中度狭窄组hs-CRP水平明显高于轻度狭窄组,组间比较有统计学差异(P㩳0.05,表3),且hs-CRP水平与狭窄程度呈正相关(r=0.345,P㩳0.01);外周血EOS计数及hs-CRP水平在冠脉病变支数分组中无统计学差异(均P㧐0.05)。采用多因素Logistic回归分析结果显示hs-CRP(OR=1.385,95%CI:1.077~1.781,P=0.011)、aTnI(OR=1.336,95%CI:1.067~1.674,P=0.011)、NT-proBNP(OR=1.002,95%CI:1.077~1.781,P=0.011)是影响患者近期MACE的危险因素。结论:外周血EOS计数与hs-CRP水平与冠脉病变之间存在相关性,hs-CRP水平越高,冠脉病变越严重;AMI患者外周血EOS计数水平会降低;hs-CRP对冠心病患者近期预后有预测意义。
[Abstract]:Objective: to detect the eosinophil count and the level of hypersensitive C-reactive protein (hs-CRP) in peripheral blood of patients with coronary artery disease (CHD). To investigate the relationship between peripheral blood EOS count, hs-CRP level and coronary artery disease and prognosis. Methods: from May 2016 to October 2016, 112 patients with coronary heart disease (CHD) in CCU ward of Department of Cardiovascular Medicine, Shanshan University first Hospital, were selected as the observation group. In the same period, 66 patients with non-coronary heart disease were taken as the normal control group, the EOS count and hs-CRP level in the admission peripheral blood were measured, and the EOS count and hs-CRP level in the peripheral blood of the two groups were compared, and the coronary heart disease patients were grouped according to the degree of coronary stenosis and the number of diseased branches. To analyze the relationship between EOS count and hs-CRP level in peripheral blood and the severity and number of coronary artery disease, the patients were divided into AMI group (UA group) and AMI group (UA group) to compare the changes of EOS count and hs-CRP level in each group. The patients in coronary heart disease group were followed up for 3 months. Results: the level of EOS in peripheral blood in AMI group was lower than that in UA group and normal control group, which was significantly higher than that in UA group and normal control group. 0. 05, Table 2. The EOS count level in severe coronary stenosis group was significantly higher than that in mild stenosis group. The level of hs-CRP in severe and moderate stenosis group was significantly higher than that in mild stenosis group. The level of hs-CRP was positively correlated with the degree of stenosis. There was no significant difference in EOS count and hs-CRP level in coronary artery disease group (all P? The results of multivariate Logistic regression analysis showed that hs-CRP OR1. 385 / 95: CI1: 1.077 1.781PnIOR1: 0.01111 TnIOR1. 336CIQ: 1. 6767 + 1. 674% P0. 01111 was the risk factor of MACE in the patients. Conclusion: the higher the EOS count in peripheral blood and the higher the level of hCRP in peripheral blood and coronary artery disease, the higher the hs-CRP level is, and the higher the correlation between EOS count in peripheral blood and the level of hs-CRP and coronary artery disease is higher, the higher the correlation between the EOS count in peripheral blood and the coronary artery disease, the higher the hs-CRP level is, and the higher the correlation is between the EOS count in peripheral blood and the coronary artery disease, and the higher the correlation between the EOS count in peripheral blood and the coronary artery disease. The more serious the coronary artery disease, the lower the level of EOS in peripheral blood of patients with coronary artery disease, and the lower the level of hs-CRP, which can predict the short-term prognosis of patients with coronary heart disease.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R541.4

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