血浆超敏C反应蛋白水平与冠心病及粥样斑块的关系

目的:探讨血浆超敏C反应蛋白(hs-CRP)水平与冠心病及粥样斑块的关系。方法:对拟诊冠心病的119例患者均行冠状动脉造影(CAG)检查[稳定性型心绞痛(SA)17例,不稳定型心绞痛(UA)45例,急性心肌梗死(AMI)27例,阴性者30例]和血浆hs-CRP水平的测定;对其中的7例SA患者、29例UA患者行血管内超声(IVUS)检查。结果:AMI者血浆hs-CRP水平显著高于UA者、SA者及阴性者(P<0·05、P<0·01);UA者显著高于SA者及阴性者(P<0·05及P<0·01);SA者与阴性者类似(P>0·05)。不稳定型斑块组血浆hs-CRP水平非常显著地高于稳定型斑块组(P<0·01)。冠状动脉中重度狭窄者血浆hs-CRP水平与轻度狭窄者类似(P>0·05)。结论:hs-CRP水平有望成为反映冠心病不稳定程度、斑块不稳定程度的敏感指标,但不能反映冠状动脉病变狭窄程度。

Clinical significance of hs-CRP level in patients with coronary artery disease and the relation between hs-CRP level and the features of atherosclerotic plaques

Objective:To elucidate the clinical significance of the circulating level of high-sensitivity C-reactive protein(hs-CRP) in patients with coronary artery disease(CAD) and the relation between hs-CRP level and the features of atherosclerotic plaques. Method:A clinical research was accomplished in 119 patients who were diagnosed as CAD initially. Research objects were divided into four groups: 30 patients in the control group with negative result in coronary angiography (CAG),17 patients in stable angina (SA) group, 45 patients in unstable angina (UA) group and 27 patients in acute myocardial infarction (AMI) group. Concentrations of hs-CRP were measured in all of the objectswho were also recieved the examination of CAG. Seven patients with SA and 29 patients with UA underwent IVUS to analyze the coronary lesions. Result:The plasma hs-CRP level was higher in AMI group compared with that in UA group (P<0.05), and was significantly higher in AMI group respectively compared with those in SA group and control group respectively (P<0.01). It was also higher in UA group compared with that in SA group (P<0.05), and was significantly higher in UA group compared with that in control group (P<0.01). Howerver, there was no difference between SA group and control group (P>0.05). The concentration of hs-CRP was significantly higher in unstable plaque group compared with stable plaque group (P<0.01), while there was no difference between slight stenosis group and medium-severe stenosis group (P>0.05).Conclusion:The circulating level of hs-CRP might reflect the unstable activity of CHD as well as the plaques, but has no relation to the stenosis of coronary artery segment.