C-反应蛋白对冠状动脉介入治疗术预后的预测价值

目的 评价稳定性冠心病患者行冠状动脉介入手术前C反应蛋白（CRP）检测对术后12个月预后的预测价值。方法 术前测定236例行择期冠状动脉介入治疗患者的基础血清C反应蛋白浓度，将患者分为CRP〈3．0mg／L组（正常组，131例）和CRP≥3．0mg／L组（异常组，105例），随访、记录和分析患者行冠状动脉介入治疗术后12个月内心血管事件（死亡、心肌梗死、心绞痛和再次血运重建术等）发生率。结果 236例患者中有105例（44％）术前CRP异常（大于3mg／L），异常组患者年龄大，吸烟者多，血脂亦高于CRP正常者（P〈0．05），而正常组更多患者使用他汀类药物（P〈0．05）。死亡、心肌梗死以及因急性冠脉综合征行急诊冠脉血流重建术发生率异常组明显高于正常组（P〈0.05），非急诊血流重建术两组相似（P〉0.05）。结论 术前C-反应蛋白水平可以预测术后心血管事件的发生，术前C反应蛋白水平升高者，术后12个月内不良心血管事件的发生明显增加，提示术前炎症反应的活性影响晚期临床结果。

The prognostic value of preprocedual serum C-reactive protein in patients undergoing elective coronary intervention

ObjectiveThe aim of the study was to assess the long term prognostic value of preprocedural C-reactive protein(CRP) in a large group of consecutive patients with coronary artery disease undergoing elective coronary intervention therapy.MethodsPreprocedural serum levels of C-reactive protein were measured in 236 patients with stable coronary artery disease undergoing coronary angioplasty.The patients were divided into two groups according to the level of CRP.The cardiovascular events(angina pectoris,myocardial infaction,death,revascularization) were carefully observed and recorded in 12 months after the procedural.ResultsAn abnormal preprocedural CRP was present in 105 of 236 patients(44%).Patients with an abnormal CRP were significantly older,were more often smokers and hypercholesterolaemic(P<0.05),whereas patients with CRP were more often on statin therapy(P<0.05).The frequency of cardiovascular events(death,myocardial infarction,ungent revascularization) was significantly high in patients with high preprocedual levels of CRP during 1-year follow-up(P<0.05).ConclusionAn increase preprocedural C-reactive protein level is a prognostic indicator for subsequent cardiac events in patients with coronary artery disease undergoing elective coronary intervention therapy,which suggests that late clinical outcome is markedly influenced by preprocedual systemic activation of inflammation.