血清高敏感C反应蛋白和老年男性冠心病的关系

The relationship between serum high-sensitivity C-reactive protein and coronary heart disease in the elderly male patients

目的 探讨血清高敏感C反应蛋白 (hsCRP)与老年男性冠心病的关系及其可能机制。方法 经冠状动脉造影证实的 6 4例老年男性患者分为冠心病组 (36例 )和对照组 (2 8例 ) ,检测血浆hsCRP水平 ,以多项临床及生化指标为危险因素进行统计分析。结果 冠心病组的hsCRP水平 (4 .73± 3.16 )mg L与对照组 (1.6 7± 1.93)mg L比较 ,差异有显著性意义。单因素logistic回归分析 ,发现hsCRP是冠心病发生的一个独立危险因素 ;高hsCRP(≥ 1.5mg L)者发生冠心病的OR值为 7.4。若把hsCRP分为三等分 ,当其每升高一个等分 ,冠心病临床病情严重程度加重一个或一个以上等级的可能性增加 3.9倍。年龄、BMI、总胆固醇、HDL C以及临床病情严重程度与hsCRP显著相关 ,但校正年龄和BMI之后 ,只有临床病情严重程度与hsCRP仍保持显著相关。结论 老年男性冠心病患者的体内炎症反映水平是升高的 ,hsCRP是老年男性冠心病患者临床病情严重程度的一个敏感指标。

Objective To investigate the relationship between the serum high-sensitivity C-reactive protein (hsCRP) levels and coronary heart disease (CHD) and explore the interaction between hsCRP and traditional risk factors in the aged male patients.Methods Serum hsCRP was measured by ultra-sensitive immunoassay in 64 Chinese male subjects (≥60 years).hsCRP values and its relationship with CHD and other factors,such as age,BMI,HDL-C,etc,were analyzed.Results The serum level of hsCRP in aged patients with CHD[( 4.73 ±3.16) mg/L] was significantly higher than that in the aged controls[(1.67±1.93) mg/L] by means of rank sum test analysis.Univariate logistic regression showed that hsCRP concentration was an independent risk factor of CHD and the OR value was 7.4 for those whose hsCRP was equal to or higher than 1.5 mg/L.Subjects were assigned to 3 groups based on their hsCRP levels and the hsCRP level was equally classified into 3 grades.In an ordinal logistic regression,the OR value of developing more serious CHD was augmented by 3.9-folds for each advancement of hsCRP to one grade higher.hsCRP was significantly correlated to those factors,such as age,BMI,TC,HDL-C and the severity of CHD.However,only the severity of CHD was significantly correlated to hsCRP after correcting for age and BMI.Conclusions The aged CHD patients have more serious inflammatory reaction than the controls and hsCRP is a sensitive predictor for the severity of CHD in the elderly male patients.