冠脉内支架植入术后血清C-反应蛋白的变化探讨

目的观察冠状动脉内支架植入术后血清C 反应蛋白 (CRP)的变化 ,并分析术后CRP浓度变化的临床意义。方法急性冠状动脉综合征组 :选择急性冠状动脉综合征 (ACS)病人 2 7例 ,行PCI;稳定性心绞痛组 :2 1例稳定性心绞痛病人 ,择期仅行冠状动脉造影 ,显示有冠状动脉不同程度狭窄 ,而未行PCI,且两组病例均严格执行冠心病二级预防治疗 ;上述两组病人用放射免疫法分别测定术前、术后 1天 ,术后 14天外周静脉血清CRP ,并以冠脉造影正常病人 2 0例作为正常对照组。结果正常对照组、稳定性心绞痛 (AP)组和急性冠脉综合征 (ACS)组 ,其血清CRP水平呈逐渐递增趋势 ,尤其是ACS组较稳定性心绞痛CRP水平升高更显著 ;PCI术后 2周血清CRP水平较术前明显降低 (P<0 .0 1)。结论CRP水平的急剧升高对急性心血管事件具有预测价值 ;介入治疗加剧了局部炎症反应 ,并随着血管开通 ,炎症反应逐渐减弱。

Study on the change of serum CRP after stenting in coronary artery

Objective To study the change of serum CRP after PCI and analysis the clinical significance. Methods 27 patients with ACS (ACS group) were treated with PCI. 21patients with stable angina (stable angina group) were only examined by ronary Angiography (CAG). 20 normal were control group. All the patients of both groups were strictly treated according to the program of coronary heart disease (CHD) secondary prevention, and were examined the level of serum CRP before and 1 day, 14 days after PCI with radioimmunity. Results The levels of serum CRP in three groups rose step by step, especially it was significantly higher in ACS group than in stable angina group. CRP was significantly lower two weeks after PCI than before. Conclusions The sharp rise of CRP is a powerful predictor of acute cardiovascular disease. The inflammatory activation can be strengthened by PCI, and gradual weak with the opening of coronary artery.