血浆高敏C反应蛋白对冠状动脉介入术后早期并发症及再狭窄的预测价值  

Preprocedural serum levels of high sensitivity C-reactive protein predict early complications and late restenosis after coronary angioplasty

作　　者：陆士娟[1] SengJun Tahk 

机构地区：[1]海口市人民医院,570311 [2]韩国亚州大学医院心脏中心

出　　处：《中国介入心脏病学杂志》2003年第6期309-311,共3页Chinese Journal of Interventional Cardiology

摘　　要：目的　探讨心绞痛患者行经皮冠状动脉介入治疗 (PCI)前 ,高敏C 反应蛋白 (hs CRP)水平对早期并发症及术后再狭窄的预测价值。方法　对 12 0例心绞痛的患者 (5 2例稳定型心绞痛 ,6 8例不稳定型心绞痛 )入院时测定血浆hs CRP水平 ,然后行单支血管的经皮冠状动脉腔内成形术(PTCA) ,随访 1年 ,观察早期并发症及晚期再狭窄发生率 ,对其进行分析。结果　 12 0例患者中 ,血浆hs CRP升高者 6 8人 ,早期并发症均发生在高hs CRP水平者。再狭窄发生率为 4 6 % ,其中血浆hs CRP正常者 14例 ,占 2 7% ;血浆hs CRP升高者 37例 ,占 6 3% (P <0 0 0 1)。经多因素回归分析显示 ,术前CRP水平增高 (r=11 7,P <0 0 0 1)、高血压 (r=4 3,P =0 0 3)、女性 (r=4 1,P =0 0 13)是预测早期并发症的独立危险因素 ,而高CRP(r=6 7,P <0 0 0 1)及术后残余狭窄 (r=3 2 ,P =0 0 0 7)是预测再狭窄的独立危险因素。结论　血浆hs CRP水平可作为炎症标志物反映冠状动脉炎症情况 ,对PTCA早期并发症及术后再狭窄有一定的预测价值。Objective To investigate whether early and late outcomes after percutaneous coronary intervention (PCI) could be predicted by baseline levels of high sensitivity C-reactive protein (hs-CRP). Methods Levels of hs-CRP were measured in 52 stable angina and 68 unstable angina patients who underwent single vessel PCI. Results Tertiles of hs-CRP levels,hypertension and female gender were independent predictors of early adverse events. Intraprocedural and in-hospital complication were higher in patients with high serum levels (>3 mg/L) of hs-CRP (28% vs 0,P <0.001). In one-year follow-up,clinical restenosis developed in 63% of patients with high hs-CRP levels and in 27% of patients with normal hs-CRP levels ( P <0.001). Tertile of hs-CRP levels and residual stenosis were independent predictors of restenosis. Conclusion Preprocedural hs-CRP level is a powerful predictor of both early and late outcomes in single vessel PCI patients.

关 键 词：血浆 高敏C反应蛋白 冠状动脉介入术 并发症 再狭窄 炎症 冠心病 

分 类 号：R446.112[医药卫生—诊断学] R815[医药卫生—临床医学]