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目的:探讨血浆超敏C反应蛋白(hs-CRP)水平与冠心病及粥样斑块的关系。方法:对拟诊冠心病的119例患者均行冠状动脉造影(CAG)检查[稳定性型心绞痛(SA)17例,不稳定型心绞痛(UA)45例,急性心肌梗死(AMI)27例,阴性者30例]和血浆hs-CRP水平的测定;对其中的7例SA患者、29例UA患者行血管内超声(IVUS)检查。结果:AMI者血浆hs-CRP水平显著高于UA者、SA者及阴性者(P<0·05、P<0·01);UA者显著高于SA者及阴性者(P<0·05及P<0·01);SA者与阴性者类似(P>0·05)。不稳定型斑块组血浆hs-CRP水平非常显著地高于稳定型斑块组(P<0·01)。冠状动脉中重度狭窄者血浆hs-CRP水平与轻度狭窄者类似(P>0·05)。结论:hs-CRP水平有望成为反映冠心病不稳定程度、斑块不稳定程度的敏感指标,但不能反映冠状动脉病变狭窄程度。
Objective: To investigate the relationship between plasma hs-CRP and coronary heart disease and atherosclerotic plaques. Methods: A total of 119 patients with suspected coronary artery disease underwent coronary angiography (CAG) in 17 patients with stable angina (SA), 45 patients with unstable angina (UA), 27 patients with acute myocardial infarction (AMI) Negative in 30 cases] and plasma hs-CRP levels; of which 7 cases of SA patients, 29 cases of UA patients underwent intravascular ultrasound (IVUS) examination. Results: The plasma levels of hs-CRP in patients with AMI were significantly higher than those with UA, SA and negative (P <0.05, P <0.01); those with UA were significantly higher than those with SA and those with negative (P <0.05 And P <0.01); SA was similar to the negative (P> 0.05). Plasma hs-CRP level in unstable plaque group was significantly higher than that in stable plaque group (P <0.01). The plasma levels of hs-CRP in moderate-severe coronary artery stenosis were similar to those in mild stenosis (P> 0.05). Conclusion: The level of hs-CRP is expected to be a sensitive index to reflect the degree of instability of coronary heart disease and plaque instability, but it can not reflect the degree of coronary artery stenosis.