慢性风湿性心脏病C-反应蛋白浓度测定及其意义

Detection and meaning of C-reactive protein in patients with chronic rheumatic valve

目的通过对86例慢性风湿性心瓣膜病C-反应蛋白(CRP)含量测定,探讨炎症在慢性风心瓣膜病中的意义。方法选取我科住院慢性风心瓣膜病患者86例,其中瓣膜置换术后风心42例,非瓣膜置换风心患者44例,与同期44名正常健康人作对照,采用速率散射比浊法测定CRP水平。结果86例慢性风心瓣膜病患者的血清CRP水平显著高于健康对照组[(0.64±0.37)mg/dl比(0.21±0.20)mg/dl,P<0.05]。其中非瓣膜置换的风心瓣膜病患者的血清CRP水平显著高于瓣膜置换术后风心组和健康对照组[(0.89±0.42)mg/dl、(0.32±0.31)mg/dl和(0.21±0.20)mg/dl,分别P<0.05和P<0.01]。瓣膜置换术后的风心瓣膜病患者的血清CRP水平高于健康对照组[(0.32±0.31)mg/dl比(0.21±0.20)mg/dl,P>0.05],差异无统计学意义。联合瓣膜病变者(24例)的血清CRP水平显著高于单瓣膜病变者(20例)[(1.49±0.77)mg/dl比(0.50±0.48)mg/dl,P<0.05]。结论炎症在风湿性心瓣膜病慢性期仍然持续存在。风湿瓣膜病变的严重性可能使CRP浓度升高。

Objective The purpose of the present study was to investigate inflammation in the progression of chronic rheumatic valve disease by detection of C-reactive protein(CRP)Methods A total of 86 patients with chronic rheumatic valve disease including 42 patients with prosthetic valve(s)and 44 healthy subjects,as a control group,determined CRP using nephelometry of velocity assays.Results The levels of hs-CRP were significantly higher in a total of 86 patients with chronic rheumatic heart disease than in healthy subjects(0.64±0.37 vs 0.21±0.20,P<0.05),with prosthetic valve(s).The levels of hs-CRP were significantly higher in patients with no-valve replacement rheumatic heart disease than in patients with prosthetic valve(s)and healthy subjects[(0.89±0.42)mg/dl vs(0.32±0.31)mg/dl vs(0.21±0.20)mg/dl,P<0.05,P<0.01,respectively),in the prosthetic valve group the hs-CRP level was higher than in healthy subjects,the difference was not statistically significant.In addition,compared with patients with one valve lesion,patients with multivalvular disease had significantly higher plasma hs-CRP levels(1.49±0.77 vs 0.50±0.48,P<0.05).Conclution This may indicate that inflammatory response still persists in the chronic rheumatic heart disease.The severity of the rheumatic valve may cause an augmented CRP production.