C反应蛋白、纤维蛋白原及肌钙蛋白T与冠状动脉粥样病变的相关性研究

The Study of Relationship between Coronary Artery Atherosclerosis Disease and C - Reaction Protein, Fibrinogen and Cardiac Troponin T

目的:本文主要探讨C反应蛋白(CRP)、纤维蛋白原(FIB)及肌钙蛋白T(cTnT)与冠状动脉粥样病变的相关性。资料与方法:入选病例经冠状动脉造影提示冠状动脉有粥样斑块者115例,男82例,女33例。年龄41～84(56±19)岁。常规入院检查。分成两组CRP≤5.0mg/L组(1组)和>5.0mg/L组(2组)。将显影的冠脉树分成15段,每段冠状动病变的程度以记分形式定量化。结果:1组和2组的单支病变的发生率分别为41％,5％(P<0.01)。3支病变发生率为3％,28％(P<0.01),冠脉病变积分分别为(1.5±1.3)分和(10.4±3.5)分(P=0.04)。2组比1组的cTnT高,组2的ECG ST-T改变明显,两组的FIB无显著性差异。结论:不稳定型心绞痛(UA)患者CRP和cTnT同时异常,同时ECG有一过性ST-T改变者预示冠脉粥样病变严重,大多数病人为3支病变或左主干病变,预后不良。对上述指标的检测有助于判断病变的严重性。

Objective: To explore relationship among C - reaction protein(CRP) ,Fibrinogen(FIB) .cardiac troponin T(cTnT) and lesion of coronary artery atherosclerosis.Materials and Methods:Patients with acute chest pain but no acute myocardial infarction were included. 1 15 cases had coronary artery atherosclerosis plaque confirmmed by coronary angiography. 82 cases male, 33 cases female, age 41 ~ 84(56 ± 19) years. CK-MB, CRP, cTnT and FIB were measured on admission, at 6 and 24 hour after admitting hospital. All of 115 cases of patients were divided into two groups: CRP f445.0mg/L(group 1); and CRP> 5.0mg/L(group 2). Angio-graphic coronary tree were divided into 15 segments. Every coronary lesion was quanified by score. Results incidence of single branch of artery disease in group 1 and group 2 was 41%, 5% individual(P < 0.01) .Incidence of three branch of artery disease in group 1 and group 2 was 3 %, 28 % individual (P < 0.01). Integral of atherosclerosis damage in group 2 was significantly higher than in group 1. Group 2 had higher cTnT than group 1. Group 2 had less depressed ST - T than group 1. Fibrinogen in two groups were not satistical-ly significant. Conclusions: CRP and cTnT were abnormal in patients with unstable angina(UA), associated with EGG transient change predicted severe coronary lesion, most patients had three branch of artery coronary lesion or left main lesion, and worse outcome. Examination of above parameters are helpful for clinicion to judge coronary artery lesion.