高敏C反应蛋白结合血管内超声对冠心病临界病变介入术后心脏不良事件的评价

目的 探讨高敏C反应蛋白(hs-CRP)联合血管内超声(IVUS)检查对冠心病临界病变介入治疗术后患者主要心脏不良事件的评价作用.方法 82例临床诊断冠心病的患者,均于术前检测hs-CRP,经冠状动脉造影检查,明确至少有一支主要冠状动脉狭窄程度在40％ ～ 70％,所有患者均行血管内超声检查,明确最小管腔面积( MLA)≤4 mm2(非左主干)或≤6 mm2(左主干)后行支架植入,将患者分为hs-CRP升高组(≥3 mg/L)和hs-CRP正常组(＜3 mg/L),比较两组在住院期间和随访期间发生典型心绞痛、非致死性心肌梗死、心源性死亡和靶血管重建等主要心脏不良事件(MACE)的发生率.结果 hs-CRP升高组主要心脏事件发生率显著高于hs-CRP正常组(P ＜0.01)；hs-CRP升高组再狭窄发生率高于hs-CRP正常组(P＜0.01).结论 hs-CRP能预测冠心病临界病变介入术后的心脏不良事件发生率,对hs-CRP升高的临界病变冠心病患者术后应强化抗血小板、抗炎等治疗.

Evaluation of hs-CRP and IVUS on major adverse cardiac event in patients with after coronary artery intermediate lesions stent implantation

Objective To investigate the impact of hs-CRP and IVUS on major adverse cardiac event in patients who after coronary artery intermediate lesions stent implantation.Methods 82 patients with clinical diagnosis of coronary heart disease who had a segmental stenosis degree is 40%~70% in one major coronary artery on coronary angiography,all of the patients do intravascular ultrasound,patients had minimal lumen area（MLA） of intermediate lesions ≤ 4mm2（the left main coronary artery）or≤ 6mm2（left main coronary artery） who received percutaneous coronary intervention（PCI）,and the patients were divided into 2 groups,hs-CRP rise group（≥3mg/L） and hs-CRP normal group（〈3mg/L）,compared the rate between the two groups in hospital and follow up periods by typical angina,nonfatal myocardial infarction,cardiac death and target-vessel revascularization and other major adverse cardiac events（MACE）.Results The rate on major adverse cardiac event in hs-CRP rise group was significantly higher than the normal group（P〈0.01）;the restenosis rate in hs-CRP rise group higher than hs-CRP normal group（P〈0.01）.Conclusion hs-CRP could predict the rate on major adverse cardiac event in patients with after coronary artery intermediate lesions stent implantation,the patients of hs-CRP rise group should strengthen antiplatelet,anti-inflammatory treatment etc.