The Correlation Study Of Inflammatory Factors And GRACE Score On The Prognosis Of Spleen Deficiency And Phlegm Turbidity Syndrome In NSTE-ACS

Purpose:To investigate the correlation between inflammatory factors such as high-sensitivity C-reactive protein(hs-CRP),interleukin-6(IL-6)and interleukin-10(IL-10)and the Global Acute Coronary Artery Event Registration Study(GRACE)score,and explore various association of factors with disease risk stratification,then explore the predictive value of influencing factors on the prognosis of patients with non-ST-segment elevation acute coronary syndrome(NSTE-ACS)spleen deficiency and phlegm turbidity syndrome,in order to identify the high-risk patients of NSTE-ACS earlier,provide reference for clinical decision making.Material and method:The data of 262 NSTE-ACS patients with spleen deficiency and phlegm turbidity syndrome were selected from 3 clinical research centers,and the general conditions and past medical history of the patients were recorded at the time of admission;blood routine,blood lipid,liver function,kidney function,and myocardial enzyme spectrum were routinely tested.Detection of inflammatory factors such as hs-CRP,IL-6 and IL-10;calculation of GRACE score and stratification of disease risk,the patients were divided into low-risk group and middle-high-risk group.During the 1-year follow-up period after discharge,patients with major adverse cardiovascular events(including readmission of ischemic chest pain,ST-segment-elevation myocardial infarction,revascularization,all-cause death,etc.)were used as event groups.Patients without cardiovascular events were included in the non-event group.Explored the linear correlation between inflammatory factors and GRACE scores,compared the differences between various indicators in the low-risk group and the medium-high-risk group,used a single factor analysis to screen the independent variables entering the prediction equation,and used two-class logistic regression to analyze the prognostic factors.The predictive ability of inflammatory factors and GRACE scores to predict the occurrence of major adverse cardiovascular events within 1 year after discharge from patients was based on the receiver operating characteristic(ROC)curve.Results:1.There was no linear correlation between GRACE score and hs-CRP,IL-6,and IL-10 levels(P>0.05).2.Age,ECG ST segment depression were statistically different between low-risk group(n =186)and middle-high-risk group(n = 76)(P<0.05).3.Age,history of diabetes,history of myocardial infarction,hs-CRP,IL-6,and IL-10 levels were statistically different between the event group(n = 54)and the non-event group(n = 208)(P<0.01 or P<0.05).4.The binary classification logistic regression equation is: logit(P)=-4.435 + 0.026 *(GRACE score)+0.14(IL-6)-0.033 *(IL-10)+0.141(hs-CRP).5.The area under the curve(AUC)of the GRACE score,IL-6,hs-CRP,IL-10,GRACE score combined with inflammatory factors(hs-CRP,IL-6,IL-10)prediction models are0.600,0.874,0.876,0.888,and 0.921;the sensitivities are 0.667,0.778,0.833,0.957,and0.852;the specificities are 0.505,0.947,0.909,0.741,and 0.952.Conclusion:1.Patient age and ECG ST segment depression may affect the risk stratification of NSTE-ACS spleen deficiency and phlegm turbidity syndrome.2.GRACE score,IL-6,hs-CRP may be independent risk factors for the prognosis of NSTE-ACS spleen deficiency and phlegm turbidity syndrom,and IL-10 may be a protective factor for the prognosis of NSTE-ACS spleen deficiency and phlegm turbidity syndrome.3.GRACE score combined with inflammatory factors(hs-CRP,IL-6,IL-10)has a better ability to assess the 1-year prognostic risk of patients with spleen deficiency and phlegm turbidity syndrome of NSTE-ACS.