Relationship between high-sensitivity C-reactive protein level and angiographical characteristics of coronary atherosclerosis

A role for inflammation has become well established over the past decade or more in theories describing the atherosclerotic disease process. From a pathological viewpoint, all stages, ie, initiation, growth, and complication of the atherosclerotic plaque, might be considered to be an inflammatory response to injury. Several prospective studies recently showed that plasma high sensitivity C-reactive protein （hsCRP） levels, which are one of the markers of systemic inflammation, are a powerful predictor of future myocardial infarction and cardiac death among apparently healthy individuals. However, the association between the plasma hsCRP levels and the extent of coronary stenosis in subjects remains controversial. Some studies previously demonstrated such associations, whereas other could not found. Gensini＇s score assigns a severity score for a stenosed vessel depending on the degree of luminal narrowing and the importance of its location.     

C反应蛋白对冠心病的应用价值

目的 :探讨 C反应蛋白 (CRP)测定在冠心病中的应用价值。方法 :测定 1 0 6例冠心病患者和 1 0 6例与之性别、年龄相匹配的正常对照者的 CRP、白细胞 (WBC)、纤维蛋白原 (FIB)及血脂水平 ,记录吸烟史、高血压病及糖尿病史 ,并计算体重指数 (BMI)。其中冠心病组又分为 3组 ,急性心肌梗死 (AMI)组 2 6例 ,不稳定心绞痛 (UAP)组 4 1例 ,SAP(稳定性心绞痛 )组 39例。比较冠心病组各组间及与对照组之间 CRP等的差异。结果 :冠心病组 CRP和 WBC水平高于对照组 (P分别为 0 .0 0 9和 0 .0 1 7) ,经调整性别、年龄、 BMI、吸烟史、高血压病及糖尿病史、血脂指标后 ,CRP和WBC水平仍与冠心病患病率显著相关 ,OR分别为 1 .72 6和 1 .4 70 (P分别为 0 .0 4 8和 0 .0 36 )。 AMI组及 UAP组CRP水平与对照组相比有显著性差异 (P=0 .0 34,P<0 .0 0 1 ) ;U AP组与 SAP组相比 ,CRP水平也有显著性差异 (P=0 .0 1 1 ) ;而 SAP组与对照组相比 CRP水平则无明显差异 (P>0 .0 5 )。结论 :CRP水平升高是冠心病的独立危险因素。 CRP可反映冠心病患者的病情严重程度     

A Preliminary Study of C—reactive Protein in the Diagnosis and Monitoring or Lyme Disease

Concentrations of C-reactive protein(CRP)in the serum of 14 patients suffering from Lyme disease were measured.86% of these patients were found to have abnormally high concentrations of serum CRP(range 14-158mg/L).The CRP concentration of a 60-yearold patient abated from 29mg/L 50 13mg/L after treatment.Results suggest that serum CRP concenttration can provide a valuable and accurate means for the clinical diagnosis and nonitoring of Lyme disease.     

冠心病与C反应蛋白

目的 探讨炎症反应与冠心病的关系。方法 测定90例冠心病（CAD）患者,其中稳定型心绞痛（SA）患者30例,不稳定型心绞痛（UA）患者32例,急性心肌梗塞（AMI）患者28例,以及正常对照组25例血清C－反应蛋白（CRP）浓度。结果 CAD患者的CRP浓度较正常组显著增高,且有统计学意义（P＜0.05,P＜0.001）。结论 炎症在动脉粥样硬化的发生发展中有一定的作用,炎性反应可能为冠心病的发病机制之一。     

Association between C-reactive protein gene ＋1059 G/C polymorphism and the risk of coronary heart disease： a meta-analysis

Background C-reactive protein （CRP） gene ＋1059 G/C polymorphism has been reported to be associated with coronary heart disease （CHD） risk, but the results remain inconclusive. This meta-analysis was therefore conducted to clarify these controversies. Methods A comprehensive search was conducted to identify all case control studies on the association between CRP gene ＋1059 G/C polymorphism and CHD risk. All the related studies were further strictly selected according to the inclusion criteria. Meta-analysis was performed with STATA 10.1 （StataCorp, USA）. The association was assessed by odds ratio （OR） and 95% confidence interval （C/）; both Begg＇s funnel plot and Egger＇s regression test were used to assess the publication bias. Results This meta-analysis on a total of 13 studies comprising 6316 CHD cases and 4467 controls showed no significant association between CRP gene ＋1059 G/C polymorphism and CHD risk in the overall study （for C/C＋C/G vs. G/G： OR=1.01, 95% C/=0.81-1.25, P=0.96; for C/C vs. C/G＋G/G： OR=1.17, 95% C/=0.77-1.77, P=0.47; for C/C vs. G/G： 0R=1.17, 95% C/=0.77-1.77, P=0.47; for C allele vs. G allele： 0R=1.01, 95% C/=0.81-1.24, P=-0.96）. However, in the subgroup analysis by ethnicity, the results showed significant association between CRP gene ＋1059 G/C polymorphism and CHD risk among Caucasians （for C/C vs. G/G： OR=2.54, 95% C1=1.13-5.72, P=0.02; C/C vs. C/G＋G/G： OR=2.45, 95% C1=1.09-5.51, P=-0.03）, but not among Asians and Africans （P 〉0.05）. Conclusion CRP gene ＋1059 G/C polymorphism may be associated with increased CHD risk among Caucasians and more evidences need to validate the conclusion.     

Comparative study of graft flow between on-pump and off-pump coronary bypass surgery for patients with multivessel coronary artery disease

Objective： To Comparatively study grafts flow between on-pump and off-pump coronary bypass surgery for patients with triple coronary artery disease. Methods ： The grafts flow was studied in 100 patients of OPCAB and compared with 100 cases of CCABG by means of Medi-Stim Butterfly Flowmeter measurement intraoperatively. Results： The mean number of the distal anastomosis was 3.78＋ 1.11 in CCABG group, and 3.83 ＋ 0.93 in OPCAB group. The index of completeness of revascularization in CCABG group was 1.01 ＋ 0.08, and 1.10＋ 0.09 in OPCAB group. The flow of grafts was satisfied in all patients. The PI values were all under 5. There was no significant difference in the mean graft flow and PI value between two groups. Conclusion： OPCAB can provide the same grafts flow and similar completeness of revascularization when compared with CCABG which indicates the similar anastomosis quality of grafts in OPCAB and CCABG groups.     

Off-pump versus on-pump coronary artery bypass surgery for the treatment of left main with triple coronary artery disease

Objective:To obtain early results of off-pump coronary artery bypass grafting(OPCAB) in patients with significant left main coro- nary artery(LMCA) and triple vessels stenosis by comparing with those of a similar group undergoing conventional coronary artery bypass surgery(CCAB). Methods:Data for patients with significant LMCA and triple vessels stenosis who underwent CCAB or OPCAB were collected retrospectively between January 1999 and May 2006. Non-randomized, retrospective data analysis included demo- graphic and preoperative risk factors, operative details, clinical outcome and early follow-up. Results: The number of distal anastomo- sis and grafts varied from 3 to 6. The average number per patient was similar in the two groups (OPCAB group:3.76± 0.98, CCAB group:3.81± 1.02). Thirty-day mortality occurred to one patient in the OPCAB group whereas two early deaths were observed in the CCAB group but did not reach statistical significance (P > 0.05). The frequency of atrial fibrillation (AF), IABP usage, mediastinitis, re-operation for bleeding (or tamponade) were similar in the two groups (P > 0.05). Postoperative inotropic requirements, peak CK- MB, ventilation time, blood loss, FFP, RBC transfusion need and the length of ICU-stay were all significantly lower in the OPCAB group compared with CCAB group(P < 0.05).Conclusion: Significant LMCA and triple-vessel stenosis can safely and effectively undergo myocardial revascularization using OPCAB surgery. LMCA should no longer be seen as a contraindication to perform OPCAB grafting.     

Clinical and angiographic characteristics of premenopausal women with coronary artery disease

Background Coronary artery disease （CAD） is generally considered as a disease of middle-aged men. It is widely accepted that the risk for CAD of premenopausal women is low because of hormone protection. Based on our clinical experience, more and more premenopausal women suffer from angina and myocardial infarction without adequate concern. Even now, there are still limited detailed data to describe the characteristics, mechanism and prognosis of premenopausal CAD patients. This article aimed to analyze the clinical and angiographic characteristics of premenopausal women with CAD.
Methods A total of 565 premenopausal women and 721 postmenopausal women （56-60 years old） who underwent coronary angiography for the first time from April 2004 to December 2007 were enrolled. The clinical data and coronary angiographic characteristics （presence, localization, length and severity） were compared between the premenopausal and postmenopausal CAD groups.
Results Premenopausal CAD patients presented less frequently with hypertension, diabetes mellitus and dyslipidemia compared with postmenopausal CAD patients （55.0% vs 66.0%, 15.0% vs 31.5%, 23.9% vs 37.4%, respectively; all P 〈0.05）. Although we found more frequent involvement of single vessel in premenopausal CAD （43.2% vs 26.9%, P=0）, and triple vessels in postmenopausal （56-60 years old） CAD patients （33.8% vs 20.4%, P=0）, much more severe lesions （z90%） at left main （2.9% vs 1.1%, P=0.048） and proximal left anterior descending artery （LAD） （28.2% vs 16.6%, P=0） in the premenopausal CAD group were found.
Conclusion Premenopausal women with chest discomfort are always found to have obvious atherosclerosis, more .inclined to be located at the left main and proximal LAD, which is a strong predictor of an adverse clinical outcome.     

冠心病患者C反应蛋白检测

冠心病的发展与动脉粥样硬化斑块的炎症反应密切相关已有较多报道〔1,2〕。炎症反应敏感指标Ｃ反应蛋白 (ＣＲＰ)与之有何关系 ?作者作了一组冠状动脉造影 (ＣＡＧ)者ＣＲＰ浓度测定 ,将结果分析如下。1　资料与方法1 .1　研究对象　 2 0 0 0～ 2 0 0 2年在本院心导管室接受选择性冠状动脉造影(ＣＡＧ)者中选取冠心病病人 (至少一支冠脉直径狭窄程度≥ 5 0 % )及冠脉正常者共 98例作为研究对象 (排除有急慢性感染 ,肿瘤及其他明显影响ＣＲＰ浓度疾患 ) ,以两种方式分组。①急性冠脉综合征 (ＡＣＳ)组 :从冠心病病人中选临床症状及ＣＡＧ结果…     

血清hsCRP水平和冠心病严重程度相关性研究

目的探讨血清高敏感C反应蛋白（hsCRP）与冠心病（CAHD）病情之间的关系。方法将经冠状动脉造影诊断的冠心病患者108例分为心肌梗死（acute myocardial infarction,AMI）组和心绞痛（anginapectoris,AP）组,检测其血浆hsCRP等生物化学指标。结果AMI组的hsCRP浓度显著高于AP组（P〈0．01）。无ST段抬高型AMI患者的hsCRP低于ST段抬高型AMI患者（P〈0．05）。AMI组WBC、N、ALT、AST和UA水平均高于AP组（P〈0．05,P〈0．01）。结论血浆hsCRP是反映CAHD患者病情的敏感指标。     

高敏C反应蛋白与冠心病病变严重程度的关系

目的:探讨高敏C反应蛋白(high sensitive C-reactive protein,hs-CRP)与冠心病(coronary heart disease,CHD)病变严重程度的关系。方法:测定经冠状动脉造影(coronary angiography,CAG)确诊的85例冠心病患者血浆中hs-CRP浓度。85例患者按照血管病变支数分为单支血管病变组(n=31)、双支血管病变组(n=26)及三支血管病变组(n=28),同时以冠状动脉造影CAG排除冠心病的32例正常人作为对照组,比较各组间血浆hs-CRP浓度。结果:冠心病患者各组hs-CRP浓度均较正常对照组增高(P<0.05)。在冠心病各亚组中hs-CRP浓度差异无统计学意义(P>0.05)。结论:冠心病患者血浆hs-CRP浓度高于正常人,但hs-CRP浓度与冠状动脉病变支数无关系。     

前白蛋白和超敏C反应蛋白与老年冠心病严重程度的关系

目的：研究血清前白蛋白（PA）和超敏C反应蛋白（hs-CRP）与老年冠心病严重程度的关系,探讨其在老年冠心病患者中的临床意义。方法：测定经冠脉造影确诊的50例年龄≥65岁的老年冠心病患者血清中PA和hs-CRP的含量。结果：老年冠心病患者血中PA含量显著低于对照组（P〈0.01）,且依照稳定心绞痛（SAP）、不稳定心绞痛（UAP）、急性心肌梗死（AMI）顺序降低（P〈0.05）;hs-CRP含量显著高于对照组（P〈0.01）,且依照SAP、UAP、AMI顺序显著增高（P〈0.05）。随着冠脉病变的支数的增加,PA含量逐渐降低（P〈0.05）,hs-CRP的含量逐渐升高（P〈0.05）。结论：PA、hs-CRP与老年冠心病患者严重程度有关,可作为临床监测老年冠心病发病及严重程度的指标。     

血浆脂蛋白(a)水平与冠状动脉病变程度的相关性研究

目的 探讨血浆脂蛋白(a)[LP(a)]水平与冠心病及冠状动脉病变程度的相关性.方法 对363例胸部不适患者进行冠状动脉造影并评价冠状动脉病变程度,按照造影结果分为冠心痛组及对照组,测定血浆LP(a)、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)浓度,进行多因素Logistic回归分析.结果 冠心病组LP (a)、TG、TC、LDL-C浓度分别为(206.00±146.00)mg/L、( 1.88±0.92)mmol/L、(5.09±0.98)mmol/L、(3.20±1.02)mmol/L、明显高于对照组(137.00±107.00)mg/L、( 1.61±0.69)mmol/L、( 4.68±0.87 )mmol/L、(2.87±0.91 )mmol/L(均P＜0.05).HDL-C浓度(0.98±0.21 )mmol/L低于对照组(1.01±0.25 )mmol/L(P ＞0.05).回归分析发现,LP(a)是冠心痛的独立危险因素.高LP(a)组Gensini积分(45.6±21.5)分明显高于低积分组(25.9±19.4)分.结论 血浆LP(a)水平是冠心病的独立危险因素,对冠状动脉病变程度有较好的预测价值.     

高敏感C反应蛋白和淀粉样物质A与冠状动脉病变程度的关系

目的:探讨血浆高敏感C反应蛋白(hs-CRP)和淀粉样物质A(SAA)与冠状动脉病变程度和病变活动性之间的关系.方法:分析94例冠状动脉造影患者的临床资料,并采用乳胶增强速率散射比浊法测定患者循环血中hs-CRP与SAA水平.结果:临床诊断急性冠状动脉综合征患者血浆hs-CRP和SAA水平为(16.34±16.02)和(9.46±6.97) mg/L,明显高于正常对照组的(1.07±1.12)和(1.24±1.11) mg/L(P＜0.01);稳定型心绞痛组为(2.76±2.31)和(2.85±2.13)mg/L,与对照组间无显著性差异;中、重度病变,单支、双支、三支病变及Gensini积分21～40分者hs-CRP和SAA水平明显高于对照组(P＜0.05,P＜0.01).结论:冠心病的发生、发展过程中存在炎症反应;血浆hs-CRP和SAA水平可作为炎症标志物反映冠状动脉炎症状况,对急性冠状动脉综合征的判断有一定价值.     

冠状动脉病变与左室结构关系分析

目的 探讨冠心病患者冠状动脉病变范围及狭窄程度与左心室结构的关系. 方法 387例选择性冠状动脉造影,证明冠心病患者252例,按冠状动脉病变范围、狭窄程度分组,造影前行心脏超声检查,对比分析冠心病患者冠状动脉病变范围及狭窄程度与左室结构的关系. 结果 随着冠状动脉病变范围的扩大,狭窄程度的加重,主动脉内径、左室前后径、室间隔厚度、左室后壁厚度、左室质量指数逐渐增加(P<0.05或P<0.01). 结论 冠状动脉病变对左室结构有一定影响,控制左室重构对冠心病患者具有重要意义.     

超敏C反应蛋白与冠状动脉病变严重程度的相关性分析

目的探讨冠状动脉粥样硬化性心脏病患者血清超敏C反应蛋白(hs-CRP)水平与冠状动脉病变严重程度的相关性。方法对162例经冠脉造影确诊为冠心病的患者检测hs-CRP,并采用改良的Gensini评分对冠状动脉血管病变程度进行分析,采用Spearman相关性分析分析冠状动脉病变与hs-CRP。结果 Spearman相关性分析显示:hs-CRP与Gensini评分之间差异有统计学意义(r=0.76,P<0.01)。结论血清中hs-CRP水平与冠状动脉病变呈正相关,其浓度随着冠状动脉病变程度的增加而升高,血清hs-CRP水平可作为冠心病患者的冠状动脉病变程度的重要参考指标之一。     

血清超敏C反应蛋白白介素6与冠状动脉病变程度的相关性

目的 探讨血清超敏C反应蛋白（hs-CRP）、白介素-6（IL-6）与冠状动脉病变严重程度的相关性。方法 选择2017年2月至2019年12月在昆明理工大学附属攀钢集团总医院住院并接受冠状动脉造影（CAG）检查的患者317例,根据CAG检查结果,将其分为正常组（n=81）与冠心病（CHD）组（n=236）。依据冠状动脉Gensini积分,将CHD组患者分为低危组132例（<20分）、中危组78例（20～40分）和高危组26例（>40分）。比较各组患者临床资料、血清hs-CRP和IL-6水平的差异。结果 CHD组患者年龄为（57.82±9.54）岁、高血压109例（46.19%）、糖尿病75例（31.78%）、低密度脂蛋白水平为（3.69±1.34）mmol/L、hs-CRP水平为（18.21±9.79）mg/L、IL-6水平为（25.70±12.62）pg/L,均高于正常组,差异有统计学意义（P<0.05）。低、中及高危组患者血清hs-CRP、IL-6水平进行比较,差异均有统计学意义（P<0.05）。高危组患者hs-CRP水平为（29.47±17.91）mg/L、IL-6水平为（35.31±8.69）pg/L,均高于低、中危组,差异有统计学意义（P<0.05）。血清hs-CRP、IL-6水平与冠状动脉Gensini积分呈正相关（P<0.05）。结论 血清hs-CRP和IL-6与冠状动脉病变程度具有一定的相关性。     

冠心病患者心力衰竭严重程度与超敏C反应蛋白水平的关系

目的：研究冠心病患者心力衰竭严重程度与超敏 C 反应蛋白水平的关系,为临床治疗冠心病伴心力衰竭提供指导策略。方法：随机选择我院的冠心病伴心力衰竭的患者150例为实验组,冠心病不伴有心力衰竭的患者150例为对照组,然后给实验组患者的心衰程度进行分级并测定实验组患者的超敏 C 反应蛋白的含量,观察二者是否存在关系,并与对照组进行对比。结果：与心功能正常相比,心衰患者的超敏 C 反应蛋白明显降低,且患者的心衰程度与超敏 C 反应蛋白水平呈负相关。结论：冠心病患者心力衰竭严重程度与超敏 C 反应蛋白水平密切相关。     

C-反应蛋白含量与冠状动脉狭窄程度关系的研究

目的:探讨C-反应蛋白(C-reactive protein,CRP)含量与冠状动脉粥样硬化病变程度的关系。方法:对506例冠脉造影患者(其中男性376例,女性130例)的冠状动脉造影结果,采用Gensini评分系统对冠状动脉血管病变程度进行定量评分,得出Gensini积分。CRP采用微粒子增强透射免疫试验检测。统计分析CRP含量与冠状动脉粥样硬化狭窄程度的关系。结果:由低至高hsCRP四分位分组后,患者的血脂、血糖以及Gensini积分在不同hsCRP组间差异有显著性。年龄、血糖和hsCRP与Gensini积分呈显著正相关,hsCRP是Gensini积分的独立影响因子。结论:血中hsCRP浓度的含量与冠状动脉病变的程度呈正相关,对冠心病的病变程度具有预测价值。