心绞痛患者C反应蛋白与冠状动脉病变稳定性和心脏事件关系的探讨  

Relation of C-reactive protein to the stability of coronary artery lesions and major adverse cardiac events.

作　　者：谷国强[1] 胡大一[2] 刘坤申[3] 商丽华[2] 路璐[2] 张岩 

机构地区：[1]河北医科大学第二医院心血管内科,050000 [2]首都医科大学附属同仁医院心血管中心,100730 [3]河北医科大学第一医院心血管内科,050000 [4]辽宁省盘锦市第二人民医院循环科,124000

出　　处：《中国实用内科杂志》2003年第11期663-665,共3页Chinese Journal of Practical Internal Medicine

摘　　要：目的　探讨C反应蛋白 (CRP)与冠状动脉病变稳定性和心脏事件之间的关系。方法　选择经冠状动脉造影证实的稳定性心绞痛 30例 ,不稳定心绞痛患者 4 5例 ,入院后即刻 ,6h ,2 4h ,4 8h和 7d检验CRP和肌钙蛋白T(cTnT) ,根据患者是否发生主要心脏不良事件进行分类研究。结果　CRP的水平与冠状动脉病变的严重程度之间没有相关性 ,不稳定心绞痛患者CRP的水平 (4 3± 0 4 )mg/L明显高于稳定性心绞痛患者 (2 2± 0 3)mg/L ,P <0 0 1。发生心脏不良事件的患者其CRP和cTnT水平在任何时点均高于未发生者 ,P <0 0 1。线形回归分析显示入院后 4 8h内的CRP ,cTnT水平对主要心脏不良事件有预测价值 ,P <0 0 1。结论　心绞痛患者C反应蛋白和冠状动脉病变严重程度之间无明显的相关关系 ,而与冠脉病变的稳定程度相关 ,CRP和cTnT联合检测可用于急性冠脉综合征的危险分层。Objective To observe the relationship between C-reactive protein (CRP) and the stability of coronary artery lesions and major adverse cardiac events.Methods By using coronary arteriography,coronary heart disease was diagnosed in 30 stable angina patients and 45 unstable ones.serum CRP and troponin T (cTnT) levels were measured on 0hs,6hs,24hs,48hs and 7days after hospital admission.The patients were divided into two groups according to the absence or presence of major adverse cardiac events.Results There was no relationship between CRP level and the severity of coronary artery lesions,whereas the CRP level of unstable angina(3.9±0.4 mg/L)was much higher than that of stable angina(2.2±0.3 mg/L),P<0.01.The levels of CRP and cTnT were higher in patients with major adverse cardiac events than those without at any time point.Linear regression analysis showed the levels of CRP and cTnT over the first 48hs after hospital admission be predictive of major adverse cardiac events (P<0.01).Conclusion CRP is correlated with the stability of coronary artery lesion,instead of its severity.The joint measurement of CRP and cTnT can detect the early onset of acute coronary syndrome.

关 键 词：心绞痛 C反应蛋白 冠状动脉病变 稳定性 心脏事件 

分 类 号：R541.4[医药卫生—心血管疾病]