Myeloperoxidase and High-Sensitivity C-Reactive Protein for Predicting Major Adverse Cardiovascular Events in Patients with Coronary Heart Disease

Background: Research has shown that high-sensitivity C-reactive protein (hs-CRP) is a major inflammatory marker for prediction of acute coronary syndrome (ACS). Myeloperoxidase (MPO) also plays an important role in atherosclerosis initiation and development. In present study, the major adverse cardiovascular events (MACEs) of patients with coronary heart disease (CHD) were investigated. Methods: MPO, hs-CRP and ACS-related risk factors from 201 ACS (78 AMI and 123 UAP) and 210 non-ACS (84 SAP and 126 non-CHD) patients confirmed by coronary angiography were detected, and the data were analyzed with receiver operating characteristic (ROC) curve and Spearman’s correlation coefficients. MACEs of 285 CHD patients were investigated during the 4-year period follow-up from March 2010 to May 2014. Results: The areas under ROC curve for diagnosing ACS were 0.888 (95% CI 0.843 - 0.933) for MPO, and 0.862 (95% CI 0.815-0.910) for hs-CRP, respectively. There were significantly correlations between MPO and hs-CRP in both ACS and non-ACS groups. Regarding to ACS patients, both MPO and hs-CRP were positively correlated with BMI, TC, TG, LDL-C and Hcy. Prospective study demonstrated that the incidences of MACEs associated significantly with elevated MPO baseline level (yes vs no, OR 7.383, 95% CI 4.095 - 13.309) and high hs-CRP baseline level (yes vs no, OR 4.186, 95% CI 2.469 - 7.097) in CHD patients. Conclusions: The present study provides the epidemiological evidence that elevated baseline MPO and hs-CRP levels are both valuable predictors of MACEs in CHD patients. MPO and hs-CRP would prompt the progression of atherosclerosis and development from SAP to ACS.

Responses of serum inflammatory factor high-sensitivity C-reactive protein, interleukin-6, and tumor necrosis factor-alpha in elderly males with cerebral infarction Non-randomized concurrent control

BACKGROUND： Cerebral infarction is poorly treated due to neuronal necrosis and secondary pathophysiological changes; for example, free radical production and inflammatory reactions. OBJECTIVE： To detect the levels of high-sensitivity C-reactive protein （hs-CRP）, interleukin-6 （IL-6）, and tumor necrosis factor- a （TNF- α ） in elderly males with cerebral infarction. DESIGN： Non-randomized current control study. SETTING： Cadre Medical Department, Guizhou Provincial People＇s Hospital. PARTICIPANTS： Forty elderly males （65-89 years old） with cerebral infarction were selected from Cadre Medical Department, Guizhou Provincial People＇s Hospital from February 2004 to December 2006. All patients met the diagnostic criteria of cerebral infarction modified at the 4th National Cerebrovascular Disease Academic Meeting, and were diagnosed on the basis of CT or MRI tests. Furthermore, 35 elderly male inpatients （65-87 years old） without cerebral infarction were selected as the control group. Included subjects provided confirmed consent and did not have heart disease, diabetes mellitus, lipid disorder, acute trauma, infection, rheumatism, or other inflammatory diseases. The study was approved by the local ethics committee. There were no significant differences in age, blood pressure, and lipid levels between the cerebral infarction group and the control group （P 〉 0.05）, and this suggested that the baseline data of both groups were comparable. METHODS： Fasting venous blood was drawn from cerebral infarction patients 24 hours after cerebral infarction attack and from control subjects 24 hours after hospitalization. A latex-enhanced immunoturbidimetric assay and an enzyme-linked immunosorbent assay were used to detect the levels of hs-CRP, IL-6, and TNF- α in the serum. MAIN OUTCOME MEASURES： The levels of hs-CRP, 1L-6, and TNF- α in the serum in both groups. RESULTS： Forty cerebral infarction patients and thirty-five control subjects were included in the final analysis without any loss. Levels of hs-CRP, IL-6, and TNF-α in the cerebral infarction group were significantly higher than those in the control group （P 〈 0.01 ）. CONCLUSION： Levels of serum inflammatory reactive factors are increased in elderly males with cerebral infarction.

High Sensitivity C-Reactive Protein Associated with Different Health Predictors in Middle-Aged and oldest old Chinese

Objective To describe the distribution of plasma high sensitivity C-reactive protein （hsCRP） and explore the relationship between hsCRP and metabolic risk factors among residents living in longevity areas of China. Methods 268 individuals aged between 40 and 59 years and 506 individuals aged over 90 years were selected from 5 longevity areas of China to participate in a cross section longitudinal cohort study. The participants were interviewed with general health related questionnaire to collect their demographic, behavioral and lifestyle data, as well as their chronic conditions, and meanwhile their physical and biomedical parameters including waist circumference （WC）, blood pressure （BP）, hsCRP, plasma lipids, and fasting blood glucose （FBG） were measured. Results The median of hsCRP was 0.99 mg/L in the middle-aged group and 2.76 mg/L in the oldest old group. No significant gender difference was observed between the above two groups. Among the oldest old individuals, 36.56% had an hsCRP level 〉3.0 mg/L. The prevalence of high hsCRP was 26.79% in the middle-aged group. The results of stepwise multiple linear regression analyses showed that HDL-C was independently associated with In （hsCRP） concentration in the middle-aged group, whereas In （TG）, HDL-C and FBG were correlated after adjustment for gender, study site, smoking, drinking, education and BMI in the oldest old group. Conclusion HDL-C is a stronger predictor of elevated hsCRP than other metabolic factors in the middle-aged population. For the oldest old persons, high TG, low HDL-C, and FBG predict elevated plasma hsCRP.

Relationship of High Sensitivity C-Reactive Protein with Cardiovascular, Diabetic, and Hepatic Biomarkers

Biomarkers are early predictors of various disorders, circulating level of C-reactive protein is a sensitive biomarker of systemic inflammation and may also be associated with the development of diabetic, hepatic, and cardiovascular diseases. In the present study, we aimed to investigate the association between circulating levels of high sensitive C-reactive protein (hs-CRP) and various biomarkers for hepatic, diabetic, and cardiovascular health. The retrospective analysis included 438 individuals who were tested for these panels simultaneously at Vibrant America Clinical Laboratory. The study population included free-living individuals without any preexisting clinical conditions. Among the cardiovascular markers, a positive correlation and significant association was found between high levels of hs-CRP and serum levels of triglycerides (r = 0.0964, p −0.1423, p −0.1216, p < 0.0105) with circulating levels of hs-CRP. Among all the diabetic markers, glucose (r = 0.1547, p < 0.0011) and glycated serum protein (r = 0.1725, p < 0.0003) were positively correlated with circulating hs-CRP. In the hepatic panel, AST, a transaminase that plays a vital role in amino acid metabolism, was found to have a strong positive correlation with hs-CRP (r = 0.2139, p < 0.0001). In conclusion, the results clearly show the association of hs-CRP with diabetic, hepatic, and cardiovascular risk factors indicating its central value as a key marker for several lifestyle-associated disorders.

Correlation of Enhancement Degree on Contrast-enhanced Ultrasound with Histopathology of Carotid Plaques and Serum High Sensitive C-Reactive Protein Levels in Patients Undergoing Carotid Endarterectomy

This study was undertaken to investigate the correlation of the enhancement degree on contrast-enhanced ultrasound(CEUS) with the histopathology of carotid plaques and the serum high sensitive C-reactive protein(hs-CRP) levels in patients undergoing carotid endarterectomy(CEA). Carotid CEUS was performed preoperatively in 115 patients who would undergo CEA, and the enhancement degree of the carotid plaques was evaluated by both the visual semiquantitative analysis and the quantitative time-intensity curve analysis. Serum hs-CRP levels were detected using the particle-enhanced immunoturbidimetric assay also before the operation. Additionally, the carotid plaque samples were subjected to histopathological examination postoperatively. The density of neovessels and the number of macrophages in the plaques were assessed by immunohistochemistry. The results showed that among the 115 patients, grade 0 plaque contrast enhancement was noted in 35 patients, grade 1 in 48 patients and grade 2 in 32 patients. The degree of plaque enhancement, the density of neovessels, the number of macrophages, and the hs-CRP levels were highest in the grade 2 patients. Correlation analysis showed that the enhancement degree of the carotid plaques was closely related to the immunohistochemical parameters of the plaques and the serum hs-CRP levels. It was suggested that the carotid plaque enhancement on CEUS can be used to evaluate the vulnerability of carotid plaques.

Clinical application of neutrophil/lymphocyte ratio combined with high sensitive C reactive protein in evaluation of community acquired pneumonia

Objective:To explore the application value of neutrophil/lymphocyte ratio (NLR) combined with high sensitive C reactive protein (hs-CRP) in the evaluation of community acquired pneumonia (CAP). Methods:From November 2015 to October 2016, 58 cases of CAP patients admitted in our department were selected as research objects and were divided into low risk group and high risk group according to the PSI score and CURB-65 standard for evaluation. They were divided into improved group (48 cases) and death group (10 cases) according to prognosis. Hs-CRP was determined by immunoturbidimetric assay, procalcitonin (PCT) by immunofluorescence, NLR by count method of laser scattering, and white blood (WBC) was counted. The differences in WBC, PCT, NLR and hs-CRP between different risk groups were compared, and the correlation was evaluated using Spearman's rank correlation analysis method. The changes in indexes were observed in the improved and death cases. Results:The high risk group had higher NLR, PCT and hs-CRP than low risk group (P<0.05), while no significant difference was found in WBC (P>0.05). No correlation was found between NLR and WBC, while a strong correlation was found between hs-CRP and PCT. The WBC, PCT, NLR and hs-CRP levels were significantly lower in the improved group than the death group (P<0.05). Conclusions:NLR combined with hs-CRP, WBC, and PCT has a good assessment of the severity of CAR, and high levels of NLR, hs-CRP, WBC, and PCT predict the severity of the disease and poor prognosis.

Relationship between coronary atherosclerosis plaque characteristics and high sensitivity C-reactive proteins, interleukin-6

Background The relationship between inflammatory markers and the characteristics of coronary atherosclerosis plaques is uncertain. The aim of the present study was to evaluate the relationship between the characteristics of coronary atherosclerosis plaques and inflammatory markers such as high sensitivity C-reactive proteins （Hs-CRP） and interleukin-6 （IL-6）. Methods All patients suspected of having coronary heart disease （CHD） underwent Siemens 64-slice CT angiography （64-SCTA） to distinguish the quality of plaque of coronary artery lesions. Blood samples were taken to measure levels of serum Hs-CRP and IL-6 in different plaque groups and the control group and compared with the value of 64-SCTA for detection of coronary artery plaque. Results The sensitivity of detecting coronary artery plaque by 64-SCTA was 87.4%, the specificity was 87.1%, the positive predictive value was 82.2%, and the negative predictive value was 91.0%. Comparing the levels of serum Hs-CRP and IL-6 among plaque groups, the mean levels of serum Hs-CRP and IL-6 in three plaque groups were significantly higher than those in the control group （P 〈0.01）. The mean levels of serum Hs-CRP and IL-6 in the soft plaque group and mixed plaque group were significantly higher than those in hard plaque group （P〈0.01）. Plaque burden in the soft plaque group and mixed plaque group was significantly higher than in the hard plaque group （P 〈0.01）, but there was no statistical difference between the soft plaque group and mixed plaque group （P=-0.246）. There was a negative correlation between the CT scale and Hs-CRP and IL-6 levels in the soft plaque group （r= -0.621, P〈0.01, and r= -0.593, P 〈0.01 respectively）. There was a positive correlation between the plaque burden and Hs-CRP and IL-6 levels in the soft plaque group （r=0.579, P〈0.05 and r=0.429, P〈0.05 respectively）. Conclusions 64-SCTA is an effective way to distinguish the different quality of coronary atherosclerosis plaque. Serum Hs-CRP and IL-6 levels can be considered as the indexes to judge the degree of CHD and may reflect the activity of plaque in CHD patients. Thus it is important for clinical diagnosis and risk evaluation of acute coronary syndrome （ACS） patients.

Associations of plasma homocysteine and high-sensitivity C-reactive protein levels with arterial stiffness in Chinese population： a community-based study

Background Arterial stiffness increases with age and is also associated with traditional cardiovascular risk factors. Little is known about the relations of homocysteine and high-sensitivity C-reactive protein （hs-CRP） to arterial stiffness in the Chinese community. The aim of the present study was to investigate the association of plasma homocysteine and hs-CRP levels with arterial stiffness in a community-based cohort. Methods We related levels of homocysteine and hs-CRP to four measures of arterial stiffness （carotid-femoral pulse wave velocity （PWV）, carotid-radial PWV, carotid-ankle PWV and heart rate corrected augmentation index） in 1680 participants from two communities of Beijing, China. Arterial stiffness was measured within two days of the time of biomarker measurement. Results In univariate analysis, homocysteine was positively associated with the carotid-femoral PWV （r=0.211, P 〈0.0001）, carotid-radial PWV （r=0.120, P 〈0.0001） and carotid-ankle PWV （r=0.148, P 〈0.0001）, whereas it was inversely related to the augmentation index （r= -0.052, P=0.016）. Hs-CRP was positively associated with the carotid-femoral PWV （r=0.074, P=0.001） and carotid-ankle PWV （r=0.050, P=0.02）. In multiple-adjusted models （R2=0.57）, homocysteine levels remained a significant determinant of the carotid-femoral PWV （standardized 13=0.065, P=0.007）, whereas the association of hs-CRP with measurements of arterial stiffness was not present. Conclusions In the Chinese population, plasma homocysteine levels are associated with alterations of aortic stiffness, whereas plasma levels of hs-CRP are not independently related to artery stiffening.

Comparision of high sensitivity C-reactive protein and matrix metalloproteinase 9 in patients with unstable angina between with and without significant coronary artery plaques

Background Inflammation within vulnerable coronary plaques may cause unstable angina by promoting rupture and erosion. C-reactive protein （CRP） is the most reliable and accessible test method for clinical use for identifying coronary artery disease event. Matrix metalloproteinase 9 （MMP-9） is highly over-expressed in the vulnerable regions of a plaque. Our aim was to evaluate the plasma levels of MMP-9 and hsCRP in subjects with both unstable angina and coronary plaques, as well as in those with unstable angina without coronary plaques.

Testosterone replacement therapy improves insulin sensitivity and decreases high sensitivity C-reactive protein levels in hypogonadotropic hypogonadal young male patients

Background Many clinical studies suggest the inverse relationship between testosterone levels and insulin sensitivity in men, however the causative relationship of these two events is still not determined. The purpose of this study was to investigate the effects of testosterone replacement therapy （TRT） on insulin sensitivity, body composition, serum lipid profiles and high sensitivity C-reactive protein （hsCRP） in hypogonadotropic hypogonadal （HH） puberty undeveloped male patients. Methods In this prospectively designed study, we compared homeostasis model assessment of insulin resistance （HOMA-IR）, insulin areas under the curves （AUC） of 3-hour oral glucose tolerance test （OGTT） and other metabolic parameters between 26 HH patients and 26 healthy men. The patients＇ HOMA-IR, insulin AUC, body composition, lipid profiles, hsCRP and other parameters were compared before and after nine-month TRT. Results The average levels of total testosterone （TT） in HH and healthy group were （0.9±0.6） nmol/L and （18.8±3.4） nmol/L, respectively. HOMA-IR in HH group was significantly higher than the healthy group （5.14±5.16 vs 2.00±1.38, P 〈0.005）. Insulin AUC in 3-hour OGTT in HH group was significantly higher than the healthy group （698.6±414.7 vs 414.2±267.5, P 〈0.01）. Fasting glucose level in H H group was significantly higher than control group （（5.1±0.6） mmol/L vs （4.7±0.3） mmol/l, P 〈0.005）. Height, weight and grasp strength of the patients were significantly increased after 9-month TRT. Significant reductions in HOMA-IR （from 5.14±5.16 to 2.97±2.16, P 〈0.01）, insulin AUC （from 698.6±414.7 to 511.7±253.9, P 〈0.01） and hsCRP （from （1.49±1.18） mg/L to （0.70±0.56） mg/L, P 〈0.05） were found after TRT. Serum total cholesterol, LDL-C, HDL-C and triglyceride were all decreased, albeit with no significant difference compared to the level prior to TRT. Conclusions HOMA-IR, insulin AUC and fasting glucose level in HH young male patients were significantly higher than those of the control group, which suggests that low level of testosterone in male adolescents might be a risk factor for insulin resistance. TRT can significantly improve patients＇ insulin sensitivity and suppress serum hsCRP, which in return suggests that TRT may prevent the HH patients from developing diabetes mellitus and cardiovascular diseases （CVD） in future.

超敏C-反应蛋白、血清降钙素原及白细胞计数在新生儿感染性疾病中的早期诊断价值

目的研究超敏C-反应蛋白(hs-CRP)、血清降钙素原(PCT)及白细胞(WBC)计数在新生儿感染性疾病的早期诊断价值,为降低临床抗生素使用率及新生儿病死率等提供科学依据。方法将2021年1月—2021年12月本院收治的62例患有感染性疾病的新生儿为病例组,同期同科室收住的50例患新生儿非感染性疾病的病例为对照组,在入院第1天和第7天分别采静脉血对比两组患儿hs-CRP、PCT和WBC的差异,计算hs-CRP、PCT和WBC灵敏度、特异度并绘制ROC曲线。结果入院时病例组hs-CRP、PCT和WBC计数均高于对照组,差异具有统计学意义(P<0.001);入院7天时,病例组hs-CRP、PCT均明显下降,与对照组差异无统计学意义(P>0.05),WBC计数虽较入院时明显下降,但仍较对照组高,差异具有统计学意义(P<0.05);hs-CRP、PCT、WBC计数和hs-CRP+PCT在诊断新生儿感染性疾病的ROC曲线下面积分别是0.954、0.962、0.732和0.985。Hs-CRP+PCT的约登指数最高,曲线下面积最大,其次是PCT、hs-CRP、WBC,差异均具有统计学意义(P<0.05)。结论hs-CRP、PCT和WBC计数在新生儿患有感染性疾病的早期均具有一定的诊断价值,hs-CRP联合PCT有助于早期判断是否使用抗生素。

Negative Association of Circulating MicroRNA-126 with High-sensitive C-reactive Protein and Vascular Cell Adhesion Molecule-1 in Patients with Coronary Artery Disease Following Percutaneous Coronary Intervention

Background： Percutaneous coronary intervention （PCI） causes endothelial damage, resulting in an inflammatory response with elevation of markers such as high-sensitive C-reactive protein （hs-CRP） and vascular cell adhesion molecule-1（VCAM-1）, which are associated with restenosis after PCI. Evidence suggests that microRNA-126 （miR-126） plays an important role in vascular inflammation, but its correlation with PCl-mediated inflammation has not been investigated. In this study, we investigated the effect of PCI on circulating miR-126 and inflammation markers such as hs-CRP and VCAM-1. Methods： We enrolled 130 patients with coronary artery disease （CAD） in the Second Hospital of Jilin University from October 2015 to December 2015. Among them, 82 patients with CAD, defined as at least one major epicardial vessel with 〉70% stenosis who planned to undergo PCI, were divided into acute coronary syndrome （ACS） group （46 patients） and stable angina （SA） group （36 patients）. Forty-eight patients confirmed by coronary angiography without PCI were used as controls. The plasmas of all patients were collected prior to PCI and at 30 min, 24 h, and 72 h after PCI. The plasma VCAM-1 and hs-CRP were detected by enzyme-linked immunosorbent assay, and the miR-126 was evaluated by quantitative reverse transcription-polymerase chain reaction. Results： Plasma concentrations of hs-CRP and VCAM-I in patients with either ACS （n = 46） or SA （n = 36） were significantly higher than in controls （n = 48） （P 〈 0.01） prior to PCI, and increased further at 24 h and 72 h after PCI, compared with prior PCI. Moreover, VCAM-1 was positively correlated with balloon time and pressure. In contrast, the plasma concentration of miR-126 was significantly lower in patients with CAD than in controls, and further decreased with time post-PCl. A negative correlation was observed between miR-126 and hs-CRP and VCAM-1 at 72 h after PCI. Conclusion： There was a negative correlation of miR-126 with the PCI-induced markers of inflammation such as hs-CRP and VCAM-1.

Relationships of High-sensitive C-reactive Protein ant P-wave Dispersion in Lone Atrial Fibrillation

Background： Current evidence links atrial fibrillation （AF） to the inflammation. Inflammatory indexes such as high-sensitive C-reactive protein （hs-CRP） have been related to the development and persistence of AF. However, the role of inflammation in the atrial electrophysiological remodeling indexed by P-wave dispersion （Pa） remains unclear. Methods： The study consisted of 71 patients with lone paroxysmal AF （AF group） and 71 age- and gender-matched controls of paroxysmal supraventricular tachycardia without history of AF （control group）. Electrocardiography, P hs-CRP, and other clinical characteristics were compared between the two groups. Results： There was no significant difference between the two groups regarding age, gender, hyperlipidemia, etc. Compared to controls, left atrial diameter （44 ± 7 vs 39 ± 7 mm）, Pd （49 ± 13 vs 26 ± 8 ms）, and hs-CRP （2.17 [1.46-2.89] vs 1.12 [0.74-1.41] rag/L） were increased （P 〈 0.05）, respectively. Linear regression identified hs-CRP as an independent correlation ofPd level both in the total population and the AF group （r = 0.464 and 0.313; P 〈 0.001, respectively）. Multiple logistic regression revealed hs-C RP as an independent determinant of AF （odds ratio [OR] =l 5.430, 95% confidence interval： 6.031-39.476： P 〈0.001）. Further adjusted tbr Pd, both Pd and hs-CRP were independent predictors for AF, but the OR for hs-CRP in predicting AF has been attenuated from 15.430 to 6.246. Conclusions： In lone AF, P and plasma hs-CRP concentration are inter-associated and related to AF. The interaction between hs-CRP and AF may be mediated by Pe, suggesting an important role of inflammation in the atrial electrophysiological remodeling predisposing to AF.

超敏C-反应蛋白、血脂、血糖检验在糖尿病新发患者检验中的作用评价

目的 探讨超敏C反应蛋白(High-Sensitivity C-Reactive Protein, hs-CRP)、血脂、血糖检验在糖尿病新发患者检验中的价值。方法 选取2021年3月—2022年10月三明市第一医院收治的86例糖尿病新发患者,设为观察组,另同期选择86名健康体检人群,设为对照组,对比两组的血糖指标、hs-CRP、血脂水平与诊断效能。结果 观察组糖化血红蛋白、空腹血糖、hs-CRP、总胆固醇、三酰甘油、低密度脂蛋白胆固醇均明显高于对照组,观察组高密度脂蛋白胆固醇明显低于对照组,差异有统计学意义(P均<0.05)。联合诊断的灵敏度、特异度、准确度分别为97.67%、95.35%、96.51%,联合诊断的诊断效能,均明显高于单独采取hs-CRP(80.23%、87.21%、83.72%)、血脂(81.40%、84.88%、83.14%)、血糖(77.91%、89.53%、83.72%)检验结果,差异有统计学意义(P均<0.05)。结论 hs-CRP、血脂、血糖指标联合检测的方式切实有效。

高敏C-反应蛋白与2型糖尿病肾病

目的 :前瞻性探讨 2型糖尿病 (DM )患者高敏C 反应蛋白 (hs CRP)与糖尿病肾病 (DN)及其发生风险的关系。方法 :应用ELISA法测定 5 5例正常对照组、6 6例不伴DN和 6 8例伴DN的 2型糖尿病患者的hs CRP水平 ,比较 3组间的差异 ;对 5 8例入组时无DN的 2型糖尿病患者进行降糖、降压等措施综合干预 ,追踪观察 5年 ,观察干预前后尿白蛋白排泄率 (UAE)、hs CRP及肾功能的动态变化。结果 :入组时 ,2型糖尿病组的血清hs CRP水平高于正常对照组 (P <0 .0 5 ) ;在年龄 ,BMI,糖尿病病程 ,平均动脉压 ,空腹血糖 ,糖化血红蛋白及血肌酐都匹配的条件下 ,入组时DN组的hs CRP水平高于无DN的DM组和正常对照组 (P <0 .0 5 ) ;2 8例在随访终点发生DN的DM患者与 30例在随访终点未发生DN患者比较 ,前者入组时和随访结束时的血清hs CRP水平高于后者 (P <0 .0 5 ) ;经降糖、降压等综合治疗 5年后 ,终点时未发生DN的DM1组血清hs CRP水平低于入组时 (P <0 .0 5 ) ,而发生了DN的DM2组终点的血清hs CRP水平虽较入组时略低 ,但差异无统计学意义 (P >0 .0 5 )。结论 :高敏C 反应蛋白水平在DM组和DN组逐渐增高 ,表明其可能是 2型DM和DN发生的危险因素 ;终点发生DN的DM患者有高水平的hs CRP基线值 ,在一定程度上能够预测 2型糖尿病患者发?

不同剂量瑞舒伐他汀对老年不稳定型心绞痛患者血清同型半胱氨酸及高敏C-反应蛋白水平的影响

目的探讨不同剂量瑞舒伐他汀对老年不稳定型心绞痛(UAP)患者血清同型半胱氨酸(Hcy)及高敏C-反应蛋白(hs-CRP)水平的影响。方法选择102例诊断明确的UAP老年患者,随机分为低剂量组(54例)和高剂量组(48例)。2组均给予阿司匹林、氯吡格雷、β-受体阻滞剂、硝酸酯类、低分子肝素等药物基础治疗。低剂量组在基础治疗上再给予瑞舒伐他汀10 mg口服,每晚1次;高剂量组在基础治疗上给予瑞舒伐他汀20 mg口服,每晚1次。治疗前及治疗3个月后测定血清Hcy、hs-CRP及血脂水平,比较2组血清Hcy、hs-CRP及血脂的变化。结果 2组治疗后血清Hcy、hs-CRP、血脂总胆固醇(TC)、低密度脂蛋白(LDL-C)、三酰甘油(TG)水平均降低,且大剂量组均优于低剂量组(P均<0.01)。2组HDL-C均升高,但2组间差异无统计学意义(P>0.05)。结论对老年UAP患者,大剂量瑞舒伐他汀不仅能充分发挥调脂作用,能更有效降低血清Hcy、hs-CRP水平。

高敏C-反应蛋白与免疫功能检测在肺炎支原体肺炎中的意义

目的探讨高敏C-反应蛋白(hs-CRP)联合免疫功能检测在儿童肺炎支原体肺炎(MPP)中的临床意义。方法选取单纯MPP患儿103例,分为全身炎症反应综合征(SIRS)组47例和非SIRS组56例,另取26例健康儿童作为对照组,检测hs-CRP、体液免疫指标及细胞免疫指标。结果 SIRS组和非SIRS组的血清hs-CRP、IgG、IgM、CD8+水平显著高于对照组,而IgA、CD3+、CD4+、CD4+/CD8+水平显著低于对照组,差异均有统计学意义(P均<0.05);SIRS组的hs-CRP、IgG显著高于非SIRS组,而IgA、CD3+、CD4+、CD4+/CD8+水平则显著低于非SIRS组,差异均有统计学意义(P均<0.05);SIRS组和非SIRS组的IgM与CD8+水平的差异则无统计学意义(P>0.05)。结论 MPP患儿的体液免疫及细胞免疫功能均有紊乱,且与病情有关;hs-CRP有助于判断儿童MPP病情程度。

牙周炎、血脂异常与超敏C-反应蛋白的关系

目的通过分析牙周炎患者的血脂指标和超敏C-反应蛋白(hs-CRP)水平,探讨牙周炎、血脂异常和hs-CRP之间的相互关系。方法体检中心体检人群中随机纳入6 190人,年龄在20～89岁。按年龄分组分为:20～40岁组、41～65岁组、≥66岁组;按是否患牙周炎分为:牙周炎组和非牙周炎组;按是否合并血脂异常分为对照组、单纯血脂异常组、单纯牙周炎组和牙周炎+血脂异常组。对所有调查对象均进行总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、脂蛋白a(lpa)和hs-CRP检测。结果与非牙周炎组比较,男性或20～40岁组的牙周炎患者hs-CRP三个水平段(1～3 mg/L、3～10 mg/L和>10 mg/L)的构成比明显升高,而41～65岁组牙周炎患者仅1～3 mg/L和3～10 mg/L两个水平段构成比升高。与单纯血脂异常组比较,单纯牙周炎组TG、LDL-C、lpa和hs-CRP水平明显降低,而牙周炎+血脂异常组TC、TG、LDL-C、LDL-C、lpa和hs-CRP水平明显升高,HDL-C水平则明显降低。结论牙周炎与血循环中hs-CRP水平升高相关,而牙周炎合并血脂异常患者的血脂水平和hs-CRP水平较单纯血脂异常者或牙周炎患者高。因此,在治疗牙周炎的同时,积极预防血脂异常能有效的降低心血管疾病的患病风险。

超敏C-反应蛋白与脑血管疾病危险因素的相关性研究

目的探讨超敏C-反应蛋白（hs-CRP）对急性脑卒中发生的影响及与脑血管疾病危险因素的关系。方法采用散射免疫比浊法检测118例急性脑卒中患者（急性脑卒中组,其中脑梗死86例,脑出血32例）和67例正常健康人（正常对照组）的hs-CRP水平,分析hs-CRP与脑血管疾病危险因素之间的关系。结果与正常对照组比较,急性脑卒中组hs-CRP水平显著升高（P〈0.01）,脑梗死组与脑出血组间比较差异无显著性。Pearson相关分析结果显示,hs-CRP值与脑血管疾病危险因素（年龄、体质指数、腹围、收缩压、舒张压、空腹血糖、甘油三酯、总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇）均呈显著相关（P〈0.05或P〈0.01）;多因素逐步回归分析结果显示,hs-CRP值与收缩压、空腹血糖、甘油三酯、总胆固醇呈显著正相关（P均〈0.01）。结论hs-CRP与急性脑卒中患病显著相关;血压、空腹血糖与血脂是影响hs-CRP的主要独立因素。

非瓣膜病性心房颤动患者血清高敏C-反应蛋白、脑钠肽、内皮素-1水平的测定及其临床意义

目的探讨不同类型非瓣膜病性心房颤动（AF）患者血清高敏C-反应蛋白（hs-CRP）、脑钠肽（BNP）、内皮素-1（ET-1）的水平差异及其在AF发生、维持及血栓栓塞事件中的作用。方法入选114例纽约心脏病协会（NYHA）心功能Ⅰ~Ⅱ级、左室射血分数〉50%的AF患者,其中慢性AF患者（慢性AF组）52例、阵发性AF患者（阵发性AF组）62例,同时选择性别、年龄、病情等与之相匹配的窦性心律患者（窦性心律组）48例,测定血清hs-CRP、BNP、ET-1水平并进行统计分析。结果两组AF患者血清hs-CRP、BNP、ET-1水平均高于窦性心律组,差异有统计学意义（P〈0.05）。慢性AF组hs-CRP、BNP水平高于阵发性AF组,差异有统计学意义（P〈0.05）;慢性AF组ET-1水平较阵发性AF组有升高趋势,但差异无统计学意义（P〉0.05）。结论 AF患者血清hs-CRP、BNP、ET-1水平升高,且慢性AF患者升高明显;hs-CRP、BNP、ET-1可能对AF的发生、维持、血栓栓塞风险有一定的预测作用,及时有效的预防和治疗可能会减少AF的发生、有益于窦性心律的维持、降低血栓栓塞事件的风险。