冠心病患者血清C反应蛋白、循环免疫复合物和补体C_3的变化及其临床意义

目的 :通过观察不同类型冠心病 (CHD)患者血清中C反应蛋白 (CRP)、循环免疫复合物 (CIC)和补体C3的水平 ,探讨炎症和免疫反应在CHD发病中的意义。方法 :将 72例经冠脉造影证实其冠脉有异常改变的CHD患者和 2 8例经冠脉造影证实其冠脉无异常改变的非冠心病患者 (NCHD)作为观察对象 ;CHD患者包括稳定型心绞痛 (SAP) 2 4例、不稳定型心绞痛(UAP) 2 8例和急性心肌梗死 (AMI) 2 0例 ,测定血清CRP、CIC和补体C3浓度。并分析浓度的改变与冠脉狭窄程度的关系。结果 :CHD组中血清CRP和CIC水平与对照组相比明显升高 (P <0 0 5 ) ,而补体C3与对照组相比无显著性差异。对CHD各亚组分析发现 ,SAP亚组仅CRP高于正常 ,其余两项均无显著性差异。UAP亚组与对照组相比 ,CRP和CIC均升高 ,差异有显著性 ,C3无明显改变 ,而且UAP亚组CRP水平比SAP组SAP水平显著升高 (P <0 0 1)。在AMI亚组中 ,三项指标均高于对照组 ,其CRP和CIC水平比SAP亚组的浓度明显增高 (P <0 0 1) ,补体C3水平虽有升高 ,但与CHD其他各亚组比较无差异。CHD患者中CIC和C3增高水平与CRP呈正相关 (r =0 69,0 65 ,P <0 0 5 )。并发现血清CRP、CIC升高水平与冠状动脉狭窄程度呈正相关 (r =0 71,0 5 7,P <0 0 5 ) ,而血清C3浓度与冠脉狭窄程度无关 (r =0

THE CHANGES OF C-REACTIVE PROTEIN CIRCULATING TMMUNE COMPLEX AND COMPLEMENT C3 IN PATIENTS WITH CORONARY HEART DISEASE AND THE CLINICAL SIGNIFICANCE

Objective:Through investigate the changes of C-reactive protein (CRP),circulating immune complex (CIC) and complement C 3 in Patients with Coronary Heart Disease,we explored the relationship between the inflammation,immuneoreaction and coronary heart disease (CHD).Methods:The levels of CRP,CIC,C 3 were measured in 72 patients with CHD,confirmed by abnormal angiography and 28 patients with normal angiography,served as control (NCHD).72 CHD were subdivided into 3 groups:24 cases of stable angina pectoris (SAP),28 cases of unstable angina pectoris (UAP) and 20 cases of acute myocardial infarction (AMI).Results:The levels of CRP and CIC in CHD group were significantly higher than those in NCHD,but the levels of C 3 had no difference between CHD group and NCHD group.In SAP group, only the levels of CRP were higher than those in CHD.In UAP group,the levels of CRP and CIC were significantly higher,but the levels of C 3 had no changes. In AMI group, the concentrations of CRP,CIC and C 3 increased obviously.In CHD patients,CIC and C 3 were positively correlated with the levels of CRP.Furthermore,there was a positive relation between the degree of coronary artery stenosis and CRP and CIC concentrations (r=0 71,0 57,P<0 05), but there was no relation between the degree of coronary artery stenosis and C 3.Conclusions:The levels of CRP,CIC and C 3 were increased gradually from SAP,UAP to AMI.There were tightly relations between them and degree of coronary artery stenosis.The results show that inflammation and abnormal immuneoreaction may play an important part in pathogenesis of CHD. The levels of CRP,CIC and C 3 may be used as indexes for the evaluation of the severity and prognosis of CHD.