C反应蛋白在冠心病及经皮冠状动脉介入治疗中意义  

Clinical significance of plasma levels of C-reactive protein in patients with coronary heart disease and undergoing percutaneous coronary intervention

作　　者：于立成[1] 王伟民[1] 师淑敏[2] 沙亚美[2] 刘键[1] 吴淳[1] 

机构地区：[1]北京大学人民医院心内科 [2]北京大学人民医院检验科,北京100044

出　　处：《临床荟萃》2004年第19期1093-1096,共4页Clinical Focus

摘　　要：目的　探讨在稳定型心绞痛 (SA) ,不稳定型心绞痛 (UA)和冠状动脉造影正常组三组病例C反应蛋白(C reactiveprotein ,CRP)水平变化的临床意义。探讨CRP变化与手术参数的相关性。探讨CRP在住院期间预测主要不良心脏事件 (majoradversecardiacevent,MACE)的价值。方法　测定入选患者 (n =97)CRP水平 ,观察冠状动脉性心脏病 (CHD)病例中高CRP水平组 (n =2 5 )及低CRP水平组 (n =35 )围手术期及住院期间MACE。结果　UA组 (n=37)CRP水平高于SA(n=2 7)和冠状动脉造影组 (n =33) [(2 3.4± 2 .3)mg/Lvs(6 .1± 8.3)mg/L ,P <0 .0 1;(2 3.4± 2 .3)mg/Lvs(4 .6± 3.7)mg/L ,P <0 .0 0 1]。经皮冠状动脉介入治疗 (percutaneouscoronaryintervention ,PCI)组 (n =39)手术后CRP水平明显增高 (P <0 .0 0 1) ,经皮穿刺冠状动脉球囊成型术 (percutaneoustransluminalcoronaryangioplasty,PTCA)总时间 >10秒与PTCA总时间≤ 10秒CRP手术前后差值差异有统计学意义 [(2 8.2±17.6 )mg/L vs(17.2± 7.1)mg/L ,P <0 .0 5 ],支架最大扩张压力 ,支架扩张总时间 ,支架长度两组间CRP手术前后差值差异均无统计学意义。高CRP组 (CRP >15mg/L)CHD围手术期及住院期间反复发作心绞痛高于低CRP组(CRP <15mg/L) (P <0 .0 5 )。Objective To observe the plasma levels of C-reactive protein(CRP) in unstable angina(UA),stable angina (SA) and normal coronary angiography(CAG) subjects.To investigate the correlativity between the levels of CRP and operative data of percutaneous coronary intervention(PCI).To evaluate the predictive value of CRP for major adverse cardiac event (MACE )of coronary heart disease(CHD) patients in the periods of operation and in-hospital.Methods A total of 97 patients ranging 34 to 76 of age were enrolled in this study.All undrerwent CAG.CRP levels of UA(n=37),SA(n=27) and normal CAG subjects (n=33) were observed.CRP levels of the patients after PCI (n=39) with that of only CAG (n=25) were contrasted.The correlativity between CRP level of one coronary stenting in PCI(n=32) and operative data were studied.Dividing the patients of CHD into a high CRP group (CRP>15 mg/L) and a low one (CRP≤15 mg/L),their MACE (including reoccurred angina,acute myocardial infarction(AMI),coronary artery bypass grafting(CABG),reundergoing PCI,sudden death) in the period of operation and in-hospital were recorded.Results Plasma levels of CRP were significantly higher in patients with UA than those with SA and normal CAG subjects[( 23.4 ± 2.3 ) mg/L vs ( 6.1 ± 8.3 ) mg/L,P< 0.01 ; ( 23.4 ± 2.3 ) mg/L vs ( 4.6 ± 3.7 ) mg/L P< 0.001 ,respectively] with no difference between the latter two groups (P> 0.05 ).Remarkably rising of CRP level was observed in patients after PCI than that of CAG only(P< 0.001 ).The group with longer total percutaneous transluminal coronary angioplasty(PTCA) seconds(>10 s) remained higher CRP level than that with shorter one(≤10 s)( 28.2 ± 17.6 mg/L vs 17.2 ± 7.1 mg/L,P< 0.05 ).The higher CRP group (CRP> mg/L) showed higher attacks of reoccurrent angina in postoperative and in-hospital than the low CRP group(CRP≤15 mg/L).Conclusion CRP level of UA group was higher than that of SA and CAG groups.There was a significant elevation of CRP levels in the patients undergoi

关 键 词：冠状动脉疾病 C反应蛋白 血管成型术 经腔 经皮冠状动脉 

分 类 号：R541.4[医药卫生—心血管疾病]