| Objective To observe the changes of serum Adropin,PTX-3 and hs-CRP levels in patients with acute coronary syndrome,and to explore the role of three indexes in the evaluation of cardiopulmonary resuscitation in patients with acute coronary syndrome,so as to provide theoretical reference for such patients to evaluate their condition and prognosis.Methods Patients with acute coronary syndrome treated in the Emergency Department and Cardiology Department of the third affiliated hospital of Inner Mongolia Medical University from December 2018 to December 2019 were studied.35 patients with sudden cardiac arrest were treated with cardiopulmonary resuscitation and 35 patients without cardiopulmonary resuscitation.All patients had chest pain within 3 hours.According to whether cardiac arrest occurred at the time of admission,patients were divided into cardiopulmonary resuscitation group and non-cardiopulmonary resuscitation group.Then according to the effect of recovery,the patients were divided into failure group and successful group.All patients who met the inclusion criteria had GRACE risk score in Emergency and clinical data were recorded.Blood samples were collected at admission,6 hours and 24 hours after admission,and venous blood samples were taken from patients to detect serum Adropin,PTX-3 and hs-CRP levels.The clinical data,GRACE score,troponin and serological indexes of each group were compared,and the correlation between each index and GRACE score was analyzed.The discharged patients were followed up by expert clinic or telephone for 1 month and 3 months,and the adverse cardiovascular events were recorded,including acute heart failure,recurrent myocardial infarction,unstable angina pectoris,severe arrhythmia and death.According to the prognosis,the patients were divided into event group and non-event group,and the clinical data and serological indexes of the two groups were compared.The role of evaluating prognosis was analyzed.SPSS 23.0 and Graph Pad Prism 8.0 were used to analyze data.Result First,the age in the failed resuscitation group was older than that in the non-resuscitation group(P<0.05).Compared with the non-resuscitation group,the heart rate was faster and the systolic pressure was lower in the failed resuscitation group and successful resuscitation group(all P<0.05).The GRACE score of failure group and successful resuscitation group was significantly higher than that of non-resuscitation group,and the score of resuscitation failure group was significantly higher than that of successful resuscitation group(all P<0.05).Second,there was no significant difference in c TNI concentration among resuscitation failure group,successful resuscitation group and non-resuscitation group at admission(P >0.05).At 6 hours and 24 hours after admission,the concentration of c TNI in the successful resuscitation group was significantly higher than that in the non-resuscitation group(all P<0.05).Compared with that at admission,the level of c TNI in successful resuscitation group and non-resuscitation group increased significantly at 6 hours after admission(all P<0.05),and showed a downward trend at 24 hours after admission,but not significantly(all P>0.05).Third,at admission,the concentration of Adropin in resuscitation failure group and successful resuscitation group was significantly lower than that in non-resuscitation group,and the concentration in resuscitation failure group was significantly lower than that in successful resuscitation group(all P<0.05).At 6 hours and 24 hours after admission,the concentration of Adropin in the successful resuscitation group was significantly lower than that in the non-resuscitation group(all P<0.05).Compared with that at the time of admission,the level of Adropin in successful resuscitation group and non-resuscitation group decreased at 6 hours after admission,but it was not significant(all P>0.05).Compared with that at the time of admission,the concentration of Adropin in both groups decreased significantly 24 hours after admission,especially in the successful resuscitation group(all P<0.05).Correlation analysis showed that there was a negative correlation between Adropin level and GRACE score at three time points.Fourth,at admission,the concentration of PTX-3 in the failed and successful resuscitation group was significantly higher than that in the non-resuscitation group,and the level in the failed resuscitation group was significantly higher than that in the successful resuscitation group(all P<0.05).At 6 hours and 24 hours after admission,the concentration of PTX-3 in the successful resuscitation group was significantly higher than that in the non-resuscitation group(all P<0.05).Compared with the time of admission,the concentration of PTX-3 in successful resuscitation group and non-resuscitation group increased significantly at 6 hours after admission(all P<0.05).The level at 24 hours after admission was significantly lower than that at 6 hours in both groups,and still higher than that at admission,and the difference was statistically significant(all P<0.05).Correlation analysis showed that there was a positive correlation between PTX-3 level and GRACE score at three time points.Fifth,at admission,there was no significant difference in hs-CRP concentration among resuscitation failure group,successful resuscitation group and non-resuscitation group(P>0.05).At 6 hours and 24 hours after admission,the concentration of hs-CRP in the successful resuscitation group was significantly higher than that in the non-resuscitation group(all P<0.05).The concentration of hs-CRP in successful resuscitation group and non-resuscitation group showed an upward trend at 6 hours and 24 hours after admission,and was significantly higher than that at admission(all P<0.05).The concentration at 24 hours after admission was significantly higher than that at 6 hours after admission,and the increase was more obvious in the successful resuscitation group,and the difference was statistically significant(all P<0.05).Correlation analysis showed that there was a positive correlation between hs-CRP level and GRACE score at three time points.Sixth,compared with the non-event group,the event group had older age,faster heart rate,lower systolic pressure and higher GRACE score(all P<0.05).At admission,6 hours and 24 hours after admission,the level of Adropin in the event group was lower and the level of PTX-3 in the event group was higher than that in the non-event group(all P<0.05).Compared with the non-event group,the hs-CRP level of the event group was higher at 24 hours after admission(P<0.05).Conclusion First,compared with non-resuscitation patients with acute coronary syndrome,resuscitation patients had lower serum Adropin and higher levels of PTX-3 and hs-CRP.Second,the concentration of serum Adropin was negatively correlated with the score of GRACE,while the concentration of PTX-3 and hs-CRP were positively correlated with the score of GRACE,which could be used to evaluate the severity of the disease.Third,the concentrations of serum Adropin,PTX-3 and hs-CRP have positive value in evaluating the short-term prognosis of patients with acute coronary syndrome. |
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