心血管疾病与C-反应蛋白

Cardiovascular disease and C-reactive protein

目的:总结并分析心房纤颤的发生机制,探讨C-反应蛋白在心房纤颤发生发展中的作用,为临床治疗心房纤颤提供新的启示。资料来源:应用计算机检索PUBMED1990-01/2005-12关于C-反应蛋白和心房纤颤与C-反应蛋白及炎症关系的文章,检索词“C-reactiveprotein,Atrialfibrillation,inflammation”并限定文章语言为English。资料选择:对资料进行初审,纳入标准:①关于C-反应蛋白的结构、生物特性及功能。②对心房纤颤发生机制及心房纤颤与C-反应蛋白相关性研究。③关于炎症与C-反应蛋白的研究。排除标准:重复性研究。资料提炼:共收集到符合上述要求的文献51篇,排除31篇重复性研究。20篇符合纳入标准,其中4篇关于C-反应蛋白生物特性研究,7篇关于心房纤颤的调查研究,9篇关于炎症与C-反应蛋白的研究。资料综合:目对前于心房纤颤发生的机制有电重构和结构重构两种。炎症可能导致肺静脉放电增加,从而触发,也可能导致心脏机构重塑,而C-反应蛋白的升高和心房纤颤的联系表明一个新的机制,炎症可能导致心房纤颤的持续性。结论:心房纤颤发生的原因是多方面的,炎症可能作为其中的一个因素而诱发,炎症与心房纤颤可能互为因果,互相促进。所以临床工作当中可以尝试采用降低C-反应蛋白的药物来预防和治疗。

OBJECTIVE： To summarize and analyze the onset mechanism of atrial fibrillation, and probe into the effects of C-reactive protein （CPR） on the development of atrial fibrillation, so as to provide new enlightenment for treatment of atrial fibrillatior, in clinic. DATA SOURCES： An computer-hased search of English articles related to CRP, atrial fibrillation and relation ship with inflammation between January 1990 and December 2005 was conducted in PUBMED with the key words of ＂C reactive protein, Atrial fibrillation, inflammation＂. STUDY SELECTION： Data were checked in the first trial. Inclusion criteria： （1）articles related to the structure, biological characteristics and function of CRP. （2）Studies about the onset mechanism of atrial fibrillation and correlation between atrial fibrillation and CRP.（3）Researches related to inflammation and CRP. Exclusion criteria： repetitive studies. DATA EXTRACTION： Fifty-one literatures in accordance with the criteria were collected, and 31 repetitive articles were excluded. Of 21 literatures in accordance with the inclusion criteria, 4 were studies of the biological characteristics of CRP, 7 were investigations of atrial fibrillation and 9 were researches about inflammation and CRP. DATA SYNTHESIS： The occurrence of atrial fibrillation was related to the reconstitution of electricity and structure. Inflammation might induce the increase of pulmonary-vein discharge and the reconstruction of heart, while correlation between increased CRP and atrial fibrillation indicated a new mechanism, and inflammation might cause the persistent atrial fibrillation. CONCLUSION： There are miscellaneous reasons for the onset of atrial fibrillation, and inflammation is one of them. Inflammation and atrial fibrillation are the cause and effect of each other. Therefore, drugs with the effects of reducing CRP can be adopted to prevent and treat atrial fibrillation in clinical practice.