C反应蛋白与不同类型冠心病的相关性研究

Correlation between C-reactive protein and coronary heart disease

目的通过观察炎症反应标志物C反应蛋白情况探讨炎症与急性冠状动脉综合征、稳定型心绞痛的关系，及其在急性心肌梗死中发生心脏事件的特点。方法96例受试者共分为3组：急性心肌梗死组28例，不稳定型心绞痛组35例，稳定型心绞痛组33例，另选对照组28例。采用免疫比浊法测定4组患者C反应蛋白含量。结果急性心肌梗死组和不稳定型心绞痛组C反应蛋白明显高于稳定型心绞痛组和对照组[分别为（113．03±61．23）、（25．26±18．13）、（5．13±3．86）、（3．26±1．98）mg／L]。急性心肌梗死组C反应蛋白显著高于不稳定型心绞痛组、稳定型心绞痛组、对照组。不稳定型心绞痛组与稳定型心绞痛组及对照组相比，C反应蛋白增高，差异均有统计学意义（P〈0．05）。稳定型心绞痛组与对照组相比，C反应蛋白升高程度的差异无统计学意义。急性心肌梗死组中C反应蛋白在发病后48h达到峰值。急性心肌梗死组中发生心脏事件患者的C反应蛋白水平[（69．23±26．22）mg／L]明显高于其中未发生心脏事件的患者[（95．34±43．45）mg／L]。结论发生急性冠状动脉综合征时C反应蛋白显著升高，表明急性冠状动脉综合征过程中存在炎症反应±，并在一定程度上反映心肌损伤及坏死的严重程度。急性心肌梗死中C反应蛋白显著升高，可较好地预测急性心肌梗死心脏事件的发生。

Objective To explore the correlation between inflammation and acute coronary syndrome （ACS）, stable angina pectoris（SAP） and to investigate characteristics of cardiovascular events in acute myocardial infarction（AMI） via detecting C-reactive protein（CRP）. Methods One hundred and twenty-four cases were divided into AMI group （28 patients） and UAP group （35 patients）. There were 33 cases in SAP group and 28 cases in normal control group. CRP concentration （mg/L） was determined by immune transmission turbidity. Results CRP significantly increased in AMI and UAP group compared with normal control group. CRP was higher in AMI group than in UAP group, SAP group and control group. CRP in UAP group was higher than in SAP group and normal control group. Compared with control group, CRP in SAP group did not significantly increase. ClIP peak occurred at 48 hours after AMI. CRP in AMI （ cardiovascular events） subgroup was higher than in AMI （ no cardiovascular） subgroup. Conclusion Significant elevation of CRP suggests that inflammation occurs in ACS courses and reflects certain degree of myocardial injury and necroses. Significant increase of CRP can predict cardiovascular events in AMI.