血清高敏C反应蛋白、颈动脉粥样硬化病变与急性冠脉综合征的关系

目的:研究血清高敏C反应蛋白(hs-CRP)水平,颈动脉粥样硬化病变表现与冠状动脉粥样硬化斑块稳定性及其病变程度之间的相互关系。方法:以急性冠脉综合征(45例,其中急性心肌梗死23例,不稳定性心绞痛22例)、稳定性心绞痛(22例)并接受冠状动脉造影检查的患者为研究对象,同时以健康者(18例)为对照,测定其hs-CRP水平。观察患者的双侧颈动脉超声,检测颈动脉内中膜厚度(IMT)、斑块形成情况,将冠状动脉病变分为1支病变、2支病变、3支病变,分析血清hs-CRP水平与不稳定性斑块的关系,颈动脉粥样硬化病变与冠状动脉粥样硬化病变程度之间的关系。结果:急性冠脉综合征患者的血清hs-CRP水平明显高于稳定冠心病者,差异有统计学意义(P<0.05);颈动脉IMT、斑块形成检出率与冠状动脉病变程度(冠状动脉病变支数)之间呈明显相关性(P<0.05)。结论:急性冠脉综合征患者血清hs-CRP水平明显升高,其升高有助于临床对动脉粥样硬化不稳定斑块的检测和诊断;颈动脉IMT、斑块形成可用于预测冠状动脉粥样硬化病变的严重程度。

Relationship between hs-CRP, carotid atherosclerosis and acute coronary syndrome

Objective:To study the relationship between the serum level of high sensitive C reaction protein(hs-CRP),carotid atherosclerosis and the coronary atherosclerotic plaque stability and the extent of coronary artery disease.Methods:Forty five patients with acute coronary syndrome(ACS)(23 patients with acute myocardial infarction,and 22 patients with unstable angina pectoris),22 patients with stable angina pectoris who underwent coronary angiography were enrolled in the study.Meanwhile 18 healthy persons were selected as control.The serum level of hs-CRP was determined by ELISA,the bilateral carotid intima-media thickness(IMT)and atherosclerotic plaques were measured by means of B mode ultrasounding,and the coronary artery disease were classified one-vessel lesion,two-vessel lesion and three-vessel lesion.The relationship between the serum hs-CRP and unstable plaque and the relationship between the carotid atherosclerosis and the extent of coronary artery disease were analysised.Results:The serum level of hs-CRP in ACS were increased significantly compared with stable coronary heart disease(P<0.05).The carotid IMT and rate of detection of plaques was also significantly correlated to the extent of coronary artery disease(P<0.05).Conclusion:The serum level of hs-CRP was increased significantly in ACS patients.It could help to detect and diagnose unstable atherosclerotic plaque.The carotid IMT and atherosclerotic plaques might be regarded as a predicative marker for the extent of coronary heart disease.