摘要目的:探讨血清超敏C反应蛋白(high-sensitivity C-reactive protein，hs-CRP)、肿瘤坏死因子α(tumor necrosis factor-alpha，TNF-α)对经皮冠状动脉介入术(percutaneous coronary intervention，PCI)患者预后的影响。方法:选择我院2016年1月至2017年12月收治的197例行PCI治疗的急性冠状动脉综合征(acute coronary syndrome，ACS)患者的临床资料进行分析，将患者按PCI术后1年是否出现主要不良心血管事件(major adverse cardiovascular events，MACE)分为MACE组和非MACE组。比较两组患者PCI前及术后48 h血清hs-CRP、TNF-α浓度，采用Logistic回归分析法分析PCI后患者发生MACE的危险因素。结果:PCI后1年随访结果，197例ACS患者PCI后发生MACE 39例，发生率为19.8%(39/197)。MACE组39例，非MACE组158例。MACE组和非MACE组患者PCI前血清hs-CRP分别为(9.70±4.71)、(7.50±4.61) mg/L，PCI后48 h分别为(15.37±5.01)、(12.16±4.38) mg/L，两组治疗前后及治疗后比较差异均有统计学意义( P均<0.01)。MACE组和非MACE组患者PCI前血清TNF-α分别为(33.1±8.9)、(25.7±8.0) ng/L，PCI后48 h分别为(47.6±8.1)、(32.4±7.6) ng/L，两组治疗前后及治疗后比较差异均有统计学意义( P<0.05或 P<0.01)。Logistic回归分析结果表明，术前血清hs-CRP、TNF-α浓度为PCI患者发生MACE的危险因素[ OR(95% CI )分别为2.069(1.715～3.358)、2.825(1.614～4.372)， P值分别为0.020、0.027]。 结论:血清hs-CRP、TNF-α浓度与PCI患者预后有关，PCI术前血清CRP、TNF-α浓度均为发生MACE的危险因素，可作为发生MACE的独立预测因素。

abstractsObjective:To investigate the effects of serum high-sensitivity C-reactive protein (hs-CRP) and tumor necrosis factor-alpha (TNF-α) on the prognosis of patients undergoing percutaneous coronary intervention (PCI).Methods:From January 2016 to December 2017, 197 patients with acute coronary syndrome (ACS) treated by PCI in our hospital were divided into MACE group (39 cases) and non-MACE group (158 cases) according to whether major adverse cardiovascular events (MACE) occurred after PCI.The serum levels of hs-CRP and TNF-α were compared between the two groups before and 48 hours after PCI.The risk factors of MACE after PCI were analyzed by logistic regression analysis.Results:One year follow-up results after PCI showed that 39 of 197 ACS patients had MACE after PCI, with an incidence of 19.8% (39/197). There were 39 cases in MACE group and 158 cases in non-MACE group.The serum hs-CRP of the MACE group and the non-MACE group before PCI were (9.70±4.71), (7.50±4.61) mg/L respectively, and 48 hours after PCI were (15.37±5.01), (12.16±4.38) mg/L, respectively.There were significant differences between the two groups (all P<0.01). The serum TNF-α levels before PCI in MACE group and non-MACE group were (33.1±8.9), (25.7±8.0) ng/L, respectively, and 48 hours after PCI were (47.6±8.1), (32.4±7.6) ng/L, respectively.There were significant differences between the two groups ( P<0.05 or P<0.01). The results of logistic regression analysis showed that preoperative serum hs CRP and TNF-α were the risk factors of mace in PCI patients (OR (95% CI) was 2.069 (1.715-3.358), 2.825 (1.614-4.372), P value was 0.020 and 0.027, respectively). Conclusion:The serum levels of hs-CRP and TNF-α are related to the prognosis of patients with PCI.The serum levels of hs-CRP and TNF-α before PCI are risk factors for MACE, which can be used as independent predictors of MACE.