C反应蛋白与急性冠脉综合症的相关性及PCI术后的变化

探讨C反应蛋白(CRP)水平与急性冠脉综合征的相关性及行经皮冠状动脉介入治疗(PCI)术后的变化。采用酶联免疫吸附试验(ELISA)法测定经冠状动脉造影确诊的57例冠心病患者及28例冠状动脉造影正常者的血清CRP水平,并比较16例行PCI术的患者术前、术后的血清CRP水平变化。血清CRP在急性心肌梗死组(15.74±1.62)mg/L明显高于不稳定型心绞痛组(11.35±2.52)mg/L,且两者明显高于稳定型心绞痛组(4.68±2.61)mg/L和正常对照组(2.68±1.16)mg/L,(P<0.01)。同时冠心病患者PCI术后血清CRP水平明显高于术前。CRP水平与ACS的临床类型密切相关,可以作为判断ACS预后的指标;PCI能导致冠心病患者的内皮损伤,加重炎症反应,可能是引起管腔内再狭窄的因素。

Relevance between C-reactive Protein and Acute Coronarterial Syndrome and Its Changes after Percutaneous Coronary Intervention

Objective：To investigate the relevance between the inflammatory marker C-reactive protein（CRP） and acute coronarterial syndrome （ACS）.And to observe the changes of CRP after percutaneous coronary intervention （PCI）.Methods：Coronary angiography （CAG） was performed in 115 hospitalized patients who were suspected as having coronary heart disease.According to the results of CAG,85 patients were divided into 2 groups：CHD group （cases,n =57） and non-CHD group （controls,n = 28）.The CHD group patients were further divided into subgroups according to the clinical types.All blood samples were collected before medication and CAG,and the plasma CRP was measured.CRP was compared statistically between the subgroups and after PCI.Results：The plasma CRP in acute myocardial infarction group （15.74 ±1.62）mg/l is significantly higher than unstable angina group（11.35 ±2.52）mg/l,and both are significantly higher than stable angina group （4.68 ±2.61）mg/l and no coronary heart disease （2.68±1.16）mg/l,（ P 0.01）.The plasma CRP after PCI got even more higher than that before PCI（P0.01）.Conclusion：Serum CRP concentration is significantly associated with severity linical process of ACS,thus it can be as an index of evaluating prognosis of ACS.PCI can damage the endothelium and exaggerate inflammatory response in patients of CHD and result in instent restenosis.