C-反应蛋白与冠心病关系的研究

Association between C-reaction protein and coronary artery disease

目的:探讨高敏C-反应蛋白(hs-CRP)水平与冠状动脉疾病的关系。方法:对经冠状动脉造影确诊或有明确心肌梗塞的冠心病患者82例和同期经冠状动脉造影证实冠状动脉无狭窄的正常对照者43例进行对照研究。所有研究对象在入院初或病情稳定48h后采清晨空腹静脉血,应用微粒子增强透射免疫分析法测定血浆hs-CRP水平。结果:冠心病组的血浆hs-CRP水平显著高于对照组(P<0.001);在冠心病组中,急性冠脉综合征(ACS)组(42例)的hs-CRP水平显著高于稳定型心绞痛(SAP)组(40例)(P<0.001),SAP组的hs-CRP水平也显著高于对照组(P<0.01)。单支病变(19例)、双支病变(23例)、三支及左主干病变(30例)组的hs-CRP水平均显著高于对照组(P分别<0.01,<0.001和<0.001)。以人群血浆hs-CRP水平的第90分位值3mg/L为截点,将冠心病组中行冠脉造影的对象分为低hs-CRP水平组和高hs-CRP水平组,可见后者多支病变(包括双支病变和三支及左主干病变)的例数(n=36)显著多于前者(n=17)(P<0.05)。结论:高敏C-反应蛋白水平可反映冠状动脉疾病及其病变的严重程度。

Objective： To investigate the association between high seneitive C-reaction protein （hs-CRP） and the coronary artery disease （CAD）. Methods： A case-control study, which enrolled 82 patients with CAD and 43 normal subjects, was performed. The CAD patients were confirmed by selective coronary angiography or diagnosed depending on a definite history of myocardial infarction. All normal subjects had normal result of coronary angiogarphy. Hs- CRP level was measured by micropartical-enhanced transmission immunoassay at the time of admission or stabilized illness status alter 48 h of hospitalization. Results： The plasma hs-CRP level was significantly higher in the CAD group than that in the control group （P〈0. 001） ; In the CAD group, the hs-CRP level remained significantly higher in the acute coronary syndrome （ACS） group （n=42） than that in the stable angina pectoris （SAP） group （n=40） （P〈 0. 001）. The hs-CRP level was also significantly higher in the SAP group than the control group （P〈0.01）. The plasma hs-CRP levels were significantly higher in the single branch lesion group （n=19）, two branches lesion group （n=23） , three branches lesion and left main branch lesion group （n=30） than that in the control group （P〈0. 01, 0. 001, 0. 001, respectively）. Using 3.0 mg/L as a cut-off value （90 percentile of the normal distribution）, the CAD group was further subdivided into low hs-CRP level group and the high hs-CRP level group. There were more patients with multiple branch lisions in the high hs-CRP level group （n=36） than those in the low hs-CRP level group （n=17） （P〈0.05）. Conclusion： The hs-CRP level is closely related to CAD and its severity.