高龄冠心病伴房颤患者hs-CRP、Hcy和颈动脉粥样硬化的检测及意义  

Hs-CRP,Hcy and carotid atherosclerosis in advanced age patients with coronary artery disease and atrial fibrillation

作　　者：卜聪亚[1] 周玉杰[1] 赵迎新[1] 韩红亚[1] 马涵英[1] 刘宇杨[1] 史冬梅[1] 李月平[1] 胡斌[1] 杨士伟[1] 王志坚[1] 

机构地区：[1]首都医科大学附属北京安贞医院心内科北京心肺血管疾病研究所北京,100029

出　　处：《临床心血管病杂志》2014年第1期59-61,共3页Journal of Clinical Cardiology

摘　　要：目的:观察高龄冠心病伴心房颤动(房颤)患者血清超敏C反应蛋白(hs-CRP)、同型半胱氨酸(Hcy)及颈动脉粥样硬化的改变。方法:选择高龄冠心病伴房颤患者(房颤组)105例,冠心病窦性心律者(窦律组)91例及窦性心律非冠心病(对照组)84例。房颤患者进一步分为阵发性房颤、持续性房颤及永久性房颤组,测定各组血清hs-CRP和Hcy水平;颈动脉超声测定颈动脉内膜-中膜厚度(IMT)及斑块Crouse积分。结果:房颤组血清hs-CRP和Hcy水平明显高于窦律组及对照组(P<0.05)。永久性房颤组hs-CRP、Hcy水平高于持续性房颤组,且均明显高于阵发性房颤组(P<0.05),显示随着房颤持续时间延长,血清hs-CRP、Hcy水平逐渐增高。同时,房颤组IMT和斑块Crouse积分明显高于窦律组及对照组(P<0.05),其中永久性房颤组高于持续性房颤组,且均明显高于阵发性房颤组(P<0.05),显示随着房颤持续时间延长,颈动脉硬化程度加重。结论:炎症和氧化应激及颈动脉粥样硬化存在于高龄冠心病伴房颤患者,随着房颤的持续而加重。Objective：To observe the changes of high sensitivity C reactive protein（hs-CRP）,homocysteine（Hcy）and carotid atherosclerosis in advanced age patients with coronary artery disease（CAD）and atrial fibrillation（Af）.Method：Patients over 80years diagnosed as CAD according to angiography were classified as Af group of 105patients with Af history and sinus thythem group of 91patients without Af history.The 84age-matched subjects without Af history and CAD were as control group.The Af group was subdivided into paroxysmal Af, persistent Af and permanent group Af as well.The levels of hs-CRP and Hcy were measured by automatically biochemistry and carotid artery ultrasound was used to detecte the carotid intima-media thickness（IMT）and the Crouse scores of plaque.Result：The levels of hs-CRP and Hcy in Af group were significantly higher than those in the sinus group and control group（P0.05）.Besides,those levels in permanent Af group were still higher than those in persistent Af group,and both of which higher than those in paroxysmal Af group（P0.05）,demonstrating the level of hs-CRP and Hcy increased gradually following with duration of Af.In addition,IMT and the Crouse scores of plaque in Af group were significantly higher than those in sinus group and control group（P 0.05）,which were higher in permanent Af group than in persistent Af group,and both of which higher than those in paroxysmal Af（P0.05）,indicating carotid atherosclerosis aggravation with the duration Af.Conclusion：The advanced age patients with CAD and Af were combine with inflammation,oxidative stress and carotid atherosclerosis as well,and are worse with duration of Af.

关 键 词：心房颤动 动脉硬化 炎症 氧化应激 高龄 

分 类 号：R541.4[医药卫生—心血管疾病]