超敏C反应蛋白与冠心病患者的冠状动脉病变程度及预后的关系

Relationship between high-sensitivity C-reactive protein and the severity and prognosis of coronary atherosclerosis of coronary heart disease

目的探讨超敏C反应蛋白水平(hs-CRP)与冠心病患者的冠状动脉病变程度及其预后的相关性。方法选取经冠状动脉造影确诊为冠心病的患者249例,根据改良Gensini评分值将其分为3组:轻度组63例,中度组96例,重度组90例。酶联免疫吸附法(ELISA)法测定各组hs-CRP水平。随机抽取133例,平均随访6月,据hs-CRP的常用对数水平的三分位数将随访对象分为3组:低水平组45例、中水平组44例、高水平组44例,比较各组主要心血管事件的发生率。结果冠心病患者hs-CRP水平随Gensini积分值增高而升高,以重度组升高明显,重度组与轻度组、重度组与中度组比较均具有显著统计学意义。多元回归分析显示hs-CRP水平不是冠状动脉病变程度的独立危险因子。随着基线hs-CRP水平升高,心血管事件发生率逐渐升高,hs-CRP高水平组主要心血管事件发生率较中、低水平组有显著性升高。结论血清hs-CRP对冠心病患者的预后判断具有重要的临床价值。

Objective To discuss the relationship between high- sensitivity C- reactive protein and the severity and prognosis of coronary atherosclerosis. Methods To analyzed 249 cases of coronary heart disease by coronary angiography with clinical data and to divide them into three groups by Gensini scoring： Minimal group 63 cases, Moderate group 96 cases, Severe group 90 cas- es. The levels of hs- CRP were detected by ELISA. Randomly selected 133 cases to follow - up, they were divided into three groups： low 45 cases, medium 44 cases, high group 44cases, compared the percentage occurrence of major cardiovascular events. Results The serum hs- CRP concentra- tion gradually increased in minimal, moderate and severe group, the level of serum hs- CRP in se- vere group was significantly higher elevations as compared with that of other groups, showed statis- tical differences between them. And a serum hs -- CRP level in CAD patients was positively relative to the modified Gensini＇s score. The level of hs - CRP was not independently associated with the modified Gensini＇s score. With the baseline hs - CRP levels, the incidence of cardiovascular events was increased significantly. Conclusion The level of serum hs- CRP maybe was not an indepen- dent risk factor of the severity of coronary atherosclerosis. Serum hs - CRP to judge the prognosis of patients with coronary artery disease has important clinical value.