血清C反应蛋白对冠状动脉支架置入术后心血管事件和再狭窄的预测价值  

The value of preprocedural serum levels of C-reactive protein in predicting cardiovascular events and restenosis after coronary stent implantation

作　　者：冯六六[1] 钱菊英[2] 周明成[1] 许其倓[1] 王齐冰[2] 蔡绳 葛均波[2] 

机构地区：[1]上海市市东医院心内科,200090 [2]复旦大学上海医学院附属中山医院心内科

出　　处：《中华心血管病杂志》2003年第7期514-516,共3页Chinese Journal of Cardiology

摘　　要：目的　探讨基础血清C反应蛋白 (CRP)水平对冠状动脉支架置入术后 6个月内心血管事件和再狭窄的预测价值。方法　术前测定 78例单支病变的冠状动脉支架置入术患者 [2 8例稳定性心绞痛 (SAP)和 5 0例急性冠脉综合征 (ACS) ]基础血清CRP水平。将患者分为CRP <3 0mg/L(31例 )和CRP≥ 3 0mg/L (4 7例 )两组 ,分析并记录患者术后 1周以及术后 6个月内心血管事件 (心绞痛、心肌梗死及死亡 )发生率及支架内再狭窄 (血管内直径狭窄率≥ 5 0 % )等情况。结果　基础血清CRP水平在ACS组比稳定心绞痛组高 [(7 8± 2 6 )比 (2 8± 0 4 )mg/L ,P <0 0 1];术后 1周内的心血管事件发生率在ACS组、CRP升高组比稳定心绞痛、CRP不高组明显升高 (8%比 3 6 % ,P <0 0 5 ) ;术后6个月的心血管事件及支架内再狭窄发生率亦是CRP高者远高于CRP低者 (2 1 5 %比 7 7% ,P <0 0 1;19 5 %比 7 7% ,P <0 0 1)。结论　基础血清CRP水平是单支冠状动脉病变支架置入术后 6个月内预后的预测指标 ,这提示术后 6个月内心血管事件发生率和支架内再狭窄是和支架置入术前炎症细胞活化程度密切相关。Objective To investigate whether the cardiovascular events in 6 months after coronary stent implantation could be predicted by baseline levels of C-reactive protein(CRP).Methods Preprocedural serum levels of CRP were measured in 78 cases (stable angina pectoris n=28, acute coronary syndrome n=50) of single coronary stent implantation.According to the level of CRP, the patients were divided into two groups: CRP<3.0 mg/L and CRP≥3.0 mg/L.The cardiovascular events(angina pectoris, myocardial infarction, death) and stent restenosis were carefully observed and recorded intraprocedural and in 1 week and 6 months after the procedures.Results The baseline levels of CRP were significantly higher in the patients with acute coronary syndrome than those with stable angina pectoris (7.8±2.6 mg/L vs 2.8±0.4 mg/L, P<0.01).The frequency of cardiovascular events was significantly higher in acute coronary syndrome and high baseline levels of CRP than those with stable angina pectoris and normal baseline levels of CRP in 1 week(intraprocedural and in-hospital)(8% vs 3.6%, P<0.05).The cardiovascular events and those in in-stent restenosis were significantly high in the patients with high baseline levels of CRP than those with normal baseline levels of CRP in 6 months too (21.5% vs 7.7%, P<0.01,19.5% vs 7.7%, P<0.01).Conclusions Preprocedural CRP level may be a predictor in 6 month outcome of patients undergoing single coronary stent implantation.It indicated that the complications and clinical restenosis in 6 months were markedly influenced by the preprocedual degree of inflammatory cell activation.

关 键 词：血清 C反应蛋白 冠状动脉支架置入术 术后并发症 心血管疾病 冠状动脉再狭窄 预测 冠心病 

分 类 号：R541.4[医药卫生—心血管疾病]