不同类型心绞痛患者冠状动脉内支架术前后血浆C反应蛋白水平的变化

目的:探讨不同类型心绞痛患者支架术前后血浆C反应蛋白(CRP)浓度的变化及其意义。方法:选择51例进行支架术的患者[支架术组,其中稳定型心绞痛(SA)13例,不稳定型心绞痛(UA)38例]作为研究对象,同时选择同期仅进行冠状动脉造影的18例心绞痛患者为对照组。2组患者分别于支架术、冠状动脉造影前当天早晨、术后48h采静脉血进行血浆CRP测定。结果:术前,SA者与对照组比较CRP水平差异无统计学意义,UA中BraunwaldⅡ级(14例)、Ⅲ级(13例)者与SA者、对照组比较CRP水平均有显著性升高[(6.23±1.24)、(6.45±0.91)mg/L∶(3.91±0.96)、(4.25±0.84)mg/L,均P<0.05],但UA各级间CRP差异无统计学意义;术后,对照组CRP浓度与术前比较差异无统计学意义,但支架术组SA者、UA各级者CRP均显著升高,且随UA临床分级增加CRP升高越显著[SA者,UAⅠ、Ⅱ、Ⅲ级者CRP分别为(6.03±0.81)、(10.73±1.02)、(14.35±2.38)、(24.40±4.21)mg/L]。支架术组术后CRP浓度与术前CRP浓度无显著直线相关(r=0.32,P>0.05)。结论:冠状动脉支架术增加不同类型心绞痛患者血浆CRP水平;UA临床分级越高,术后CRP水平升高越明显,CPR水平可作为冠状动脉病变不稳定性的预测指标。

Variation of plasma C-reactive protein levels before and after coronary stent implantation in angina pecton''''s

Objective:Variation of plasma C-reactive protein levels before and after coronary stent implantation in Angina pecton's.Method:Fifty-one patients with angina (13 cases of stable angina,SA group and 38 of unstable angina,UA group) with coronary stent implantation were included, and 18 patients who only received coronary angiography (CAG) during the same period were selected as control group. Venous blood for CRP measuring was drawn in the early morning of the procedure and 48 hours after the procedure. Result:Before the procedure, there was a significant difference in CRP between the SA group and each UA group, whereas there was no significant difference in CRP between the SA group and the control group, also between each of the UA groups. There was a significant increase in CRP in SA group and in the individual groups with UA after stent implantation. A significant increase on CRP levels in SA group and each of the UA groups was found after stenting. No significant increase in CRP was induced by CAG. Besides, CRP levels were significantly higher in patients with lesions types B and C compaired with type A. There was no significant relation in CRP between post- and pre-stenting (P>0.05). Conclusion:Coronary stent implantation induced a detectable increase in plasma C-reactive protein levels. There was significant increase in CRP levels after the procedure among the individual groups with unstable angina, which may suggest that CPR levels would predict the grade of instability of coronary lesions.