超敏C反应蛋白对特发性室性期前收缩预后评估的价值

目的 特发性室性期前收缩患者无器质性心脏病证据，但可能存在心脏的潜在病变；超敏C反应蛋白（hs-CRP）可能反映心脏的潜在病变，从而对室性期前收缩的预后评估具有一定的价值。方法 对2010~2015年在笔者医院心内科住院的特发性室性期前收缩患者进行24h动态心电图检查，分析室性期前收缩的临床特点，并计算心率振荡指标（振荡初始和振荡斜率）评价心脏自主神经功能。采集静脉血，检测hs-CRP水平，将患者分为hs-CRP正常组和hs-CRP升高组，分析hs-CRP水平与室性期前收缩临床特征的相关性。结果 共纳入109例特发性室性期前收缩患者，其中hs-CRP正常组88例，hs-CRP升高组21例。hs-CRP升高的患者血压水平较高，心脏自主神经功能减退，多形性室性期前收缩的发生率显著增加，Logistic回归表明hs-CRP水平是多形性室性期前收缩的危险因素。结论 在特发性室性期前收缩患者中，hs-CRP升高可能反映心脏的潜在病变和心脏自主神经功能减退，与多形性室性期前收缩的发生相关，对特发性室性期前收缩的预后评估具有重要意义。

Prognostic Value of High Sensitivity C-reactive Protein for Idiopathic Ventricular Premature Contractions

Objective There is no evidence for organic heart diseases in patients with idiopathic premature ventricular contractions (PVCs), while some latent pathological changes may exist. High sensitivity C-reactive protein (hs-CPR) might reveal the latent changes in the heart and thus could have prognostic value for idiopathic PVCs. Methods Patients with idiopathic PVCs admitted during 2010-2015 were enrolled. Holter ECG was performed to analyze clinical features of PVCs and heart rate turbulence indices (turbulence onset and turbulence slope) were calculated to evaluate cardiac autonomic function. Serum hs-CRP was determined and patients were divided into normal group and elevated group based on hs-CRP levels. The associations between hs-CRP levels and clinical features of PVCs were analyzed. Results A total of 109 patients were enrolled including 88 patients with normal hs-CRP and 21 patients with elevated hs-CRP. The patients in elevated group had increased blood pressure, impaired cardiac autonomic function, and significantly increased incidence of polymorphic PVCs. Furthermore, high hs-CRP levels were risk factors for polymorphic PVCs as revealed by binary Logistic regression. Conclusion In patients with idiopathic PVCs, high hs-CRP levels might reveal the latent pathological changes and impaired autonomic function in the heart and were significantly related to high incidence of polymorphic PVCs. Hs-CRP might have a certain prognostic value for idiopathic PVCs.