不同临床及血管病变类型的患者行介入治疗术后hs-CRP变化规律探讨

目的 探讨不同临床类型及不同冠状动脉病变类型的冠心病患者行经皮冠状动脉介入（PCI）治疗术后超敏C-反应蛋白（hs-CRP）的变化规律。方法 100例行PCI治疗的冠心病患者，按临床类型分为稳定型心绞痛（SAP）组、不稳定型心绞痛（UAP）组和急性心肌梗死（AMI）组；按冠状动脉病变类型分为A型病变组、B型病变组和C型病变组。分别于PCI治疗术前、术后5个时间点抽取静脉血，检测血清hs-CRP。结果 （1）100例患者术前hs-CRP均高于正常标准值。（2）100例患者术后hs-CRP较术前升高。（3）SAP组术后6h hs-CRP开始升高，48h达到高峰，72h开始下降；UAP组及AMI组均于术后12h hs-CRP开始升高，72h开始下降，其中UAP组术后48h达到高峰，AMI组术后24h达到高峰。（4）A型病变组术后24h hs-CRP开始升高，持续至72h，其间无明显峰值；B型病变组和C型病变组术后12h hs-CRP开始升高，峰值在48h，72h开始下降。结论 PCI治疗术后炎症反应的状态不仅与术前临床类型及冠状动脉病变类型有关，更与PCI治疗过程密切相关。

Changes of high sensitive C - reactive protein after percutaneous coronary intervention in different types of coronary heart diseases

Objective To investigate the regulation of the serum level of high sensitive C-reactive protein(hs-CRP) in patients with coronary heart disease(CHD) by percutaneous coronary intervention(PCI) therapy.Methods One hundred patients who underwent successfully PCI were divided into stable angina pectoris(SAP) group,unstable angina pectoris(UAP) group and acute myocardial infarction(AMI)group according to clinical type.Type A group,type B group and type C group according to lesion complexity.Samples of peripheral serum in all groups were obtained to determine the serum hs-CRP levels before and 6,12,24,48,72 h after PCI therapy.The observed figures were statistically analyzed.Results(1)The serum hs-CRP levels before operation were higher than normal value.(2)The serum hs-CRP levels after PCI therapy were obviously higher than those before operation.(3)In SAP group,the hs-CRP levels of 6 h after PCI therapy went up obviously,48 h after PCI therapy attained the peak,72 h after PCI therapy descended.In UAP group and AMI group,the hs-CRP levels of 12 h after PCI therapy went up obviously,72 h after PCI therapy descended.In UAP group,48 h after PCI therapy attained the peak.In AMI group,24 h after PCI therapy attained the peak.(4)In type A group,the hs-CRP levels of 24 h after PCI therapy went up obviously and keeping on to 72 h after PCI therapy.In type B group and type C group,the hs-CRP levels of 12 h after PCI therapy went up obviously,peak value was at 48 h after PCI therapy,72 h after PCI therapy descended.Conclusion The inflammation reaction after PCI therapy is not only related with coronary lesion complexity and clinical type before PCI therapy,even more related with intervention process.