C反应蛋白水平与传统冠心病危险因素分析

目的了解江苏省人群C反应蛋白（CRP）的水平与传统冠心病（CHD）危险因素的关系。方法通过“江苏省多代谢异常和代谢综合征综合防治研究”资料，比较高敏C反应蛋白（hs—CRP）（hs—CRP：1～2．99mg／L和≥3mg／L）与传统CHD危险因素：体重指数（BMI）、吸烟、高血压、高血糖、高胆固醇、高三酰甘油、低高密度脂蛋白胆固醇、体力活动缺乏等的关系。结果高hs—CRP罹患率均随血压、血糖、胆固醇、三酰甘油、BMI、吸烟、体力活动（无、轻、中、重）增加而增高，但当hs-CRP（1-2．99mg／L）时，传统CHD危险因素中大部分未表现出显著联系；随着Framingham心脏积分（5个危险因素）合并数量增加，高hs-CRP呈明显的等级性变化趋势；logistic回归分析表明，hs—CRP（≥3mg／L）时，BMI、三酰甘油、高血压、高密度脂蛋白胆固醇、吸烟、血糖的OR值均有统计学意义，但hs—CRP（1～2．99mg／L）时，传统CHD危险因素的OR估计值大部分无统计学意义；男性中60．98％和女性中59．02％的高CRP可以归因于传统CHD危险因素。结论传统CHD危险因素与hs—CRP水平关系密切，目前在临床上、人群研究中根据CRP水平的高低判断CHD风险的实际意义值得进一步探讨。

Study On C-reactive protein and the risk factors of traditional coronary heart disease

OBJECTIVE: To ascertain the relationship between C-reactive protein (hs-CRP) and risk factors of traditional coronary heart disease (CHD) in a sampled population from Jiangsu province of China. METHODS: Using data derived from a project on multiple metabolic disorders and metabolic syndrome in Jiangsu province, a cross-sectional study was carried out. Criteria was set as: CRP level categories from 1 to 2.99 mg/L, and greater than 3 mg/L, to explore the relationship between different category of CRP and risk factors of traditional coronary heart disease which would include body mass index (BMI), cigarette smoking, high blood pressure, blood glucose, total cholesterol level, triglyceride (TG), high-density lipoprotein cholesterol (HDL-C) level, physical activity etc. RESULTS: The attack rate of high CRP increased with the degree of risk factors related to traditional coronary heart disease. However, when hs-CRP fell between 1-2.99 mg/L, part of the traditional risk factors would display significance. Significance increased in high CRP related to grading was observed across the Framingham heart score (quintiles). Data from the logistic regression analysis showed that: when hs-CRP (> or =3 mg/L), the OR of BMI, TG, high blood pressure, HDL-C, cigarett smoking, blood glucose all appeared statistical significance whereas hs-CRP between 1-2.99 mg/L, the OR of trational CHD risk factors did not show statistical significance but 60.98% of the males and 59.02% of the females would have high hs-CRP incriminate traditional CHD risk factors. CONCLUSION: As the close relationship between traditional CHD risk factors and hs-CRP was seen, the role of hs-CRP in estimating the risk of CHD was limited, despite the origin of data, either from clinical or from cohort study.