关键词: 冠心病, 血红蛋白测定, 预后, 尿蛋白定性分级, 介入治疗

Abstract: Abstract：Objective To investigate the predictive value of treatment outcome combined analysis of preoperative urinary protein and hemoglobin (HB) levels for percutaneous coronary intervention (PCI). Methods One thousand one hundred and ninety-five PCI patients were divided into six groups by qualitative determination of urine albumin and HB levels. The proteinuria was defined as normal (urine dipstick negative), mild (urine dipstick trace or + ), or heavy (urine dipstick≥++). A group: urine albumin negative, no anemia (n=701); B group: mild urine albumin (+), no anemia (n=247)；C group: heavy urine albumin (++～++++), no anemia (n=41); D group: urine albumin negative, anemia (n=134); E group: mild urine albumin, anemia (n=52)；F group: heavy urine albumin (++～++++ ), anemia（n=20). The prognostic factors of PCI patients were analyzed by Cox proportional hazards models. The prediction value of cardiac events after PCI was evaluated by the area under the ROC curve. Logistic model was carried out to get the fitting variable for ROC curve analysis. Kaplan Meier survival analysis was used to compare survival curves between groups with different levels of urine protein, different levels of hemoglobin, and joint analysis. Results There were significant differences in age, diabetes, myocardial infarction and left ventricular ejection fraction (LVEF) between six groups (P＜0.05). Multiple factors regression analysis showed that positive urine protein, anemia, and more than one vessel count of lesion were the risk factors for cardiovascular events after PCI surgery. The combination of urine protein and hemoglobin showed the highest Jordan index in the prognosis evaluation of PCI. The best cut-off value for predicting clinical adverse events of urinary protein was 0.125 g/L. The best cut-off value for hemoglobin was 130 g/L. Survival analysis showed there were significant differences in the cumulative survival rates between the anemia group and the non-anemia group, the negative urinary protein group, the positive + group, the positive≥++group (P＜0.05). The cumulative survival rate of F group with anemia and urinary protein-positive ≥++ was significantly lower than that of other groups. With the aggravation in urinary protein and appearance of anemia, the cumulative survival rate was gradually reduced in each level. Conclusion Preoperative urinary protein and hemoglobin are correlated with the prognosis of coronary heart disease in patients after interventional therapy, and their combined evaluation is of great significance in guiding clinical treatment

Key words: coronary disease, hemoglobinometry, prognosis, urinary protein qualitative classification, interventional treatment