心血管疾病患者血清超敏C-反应蛋白与摄氧效率斜率的相关性研究

目的探讨心血管疾病患者炎症因子超敏C-反应蛋白（hs-CRP）与摄氧效率斜率（OUES）的相关性。方法选择经皮冠状动脉介入治疗后患者17例，稳定型心绞痛21例，原发性高血压24例。采用症状限制性标准Bruce分级平板运动方案，同时测定摄氧量（V_O2）、每分通气量（VE）。采用对数曲线拟合的方法，建立回归方程：V_O2=a×lgVE+b，计算a为OUES值。应用全自动免疫散射比浊法检测血清hs-CRP。超声心动图测定左心室射血分数（LVEF）。结果血清lg(hs-CRP)与OUES75（r=-0.506,P＜0.001）、OUES100（r=-0.567,P＜0.001）、LVEF（r=-0.286,P＜0.01）呈负相关。多元逐步回归分析显示，lg(hs-CRP)（β=-0.374，P=0.006）、身高（β=-1.854，P=0.036）、体重（β=-5.033，P=0.034）是OUES75降低的危险因素；lg(hs-CRP)（β=-0.396，P=0.003）、身高（β=-2.157，P=0.013）、体重（β=-5.912，P=0.011）是OUES100降低的危险因素。结论血清hs-CRP可能是反映心肺储备功能及左室收缩功能的有效标记物。

Correlation between High-sensitivity C Reactive Protein and Oxygen Uptake Efficiency Slope in Patients with Cardiovascular Disease

ObjectiveTo investigate the relationship between high-sensitivity C reactive protein （hs-CRP） and oxygen uptake efficiency slope (OUES) in patents with cardiovascular disease. MethodsExercise tests, following a symptom-limited standard Bruce protocol with simultaneous respiratory gas-exchange measurements, were performed on a treadmill in 17 post-PCI patients, 21 stable angina pectoris and 24 patients with essential hypertension (EH). The oxygen uptake (V_O2), minute ventilation (VE) were determined. The OUES was derived from the relation between V_O2 (ml/min) and VE (L/min) during incremental exercise and was determined by V_O2=a×lgVE+b, where a = OUES. The OUES was calculated from data of the first 75% (OUES75) and 100% (OUES100) of exercise duration. The serum hs-CRP was measured by immunoassays, and the left ventricular ejection fraction (LVEF) was measured with echocardiography. ResultsOUES75 （r=-0.506,P＜0.001）, OUES100 （r=-0.567,P＜0.001） and LVEF （r=-0.286,P＜0.01） were correlated with lg(hs-CRP). In stepwise multivariable linear regression models, lg(hs-CRP) （β=-0.374，P=0.006）, body height （β=-1.854，P=0.036）, body weight （β=-5.033，P=0.034）were independent risk factors of lower OUES75. lg(hs-CRP) （β=-0.396，P=0.003）, body height （β=-2.157，P=0.013）, body weight （β=-5.912，P=0.011） were independent risk factors of lower OUES100. ConclusionThe serum leveles of hs-CRP may be the useful marker that reflecting cardiopulmonary functional reserve and left ventricular function.