目的:探讨早发冠心病患者血浆C反应蛋白与临床表型及冠状动脉病变的关系,以期为冠心病早期康复措施介入提供理论依据。方法:采用Judkins法进行冠状动脉造影明确早发冠心病及正常对照组。冠心病诊断系指至少有一支冠状动脉直径减少≥50%和临床确诊为心肌梗死。应用散射比浊法测定研究对象血浆C反应蛋白。早发冠心病临床表型分为急性心肌梗死、不稳定性心绞痛和稳定性心绞痛;根据冠状动脉狭窄程度计算冠状动脉病变积分;采用病例对照的方法进行对比研究。结果:病例组患者血浆C反应蛋白水平犤(7.5±1.6)mg/L犦明显高于对照组犤(3.2±1.3)mg/L犦(t=7.431,P<0.01)。病例组C反应蛋白正常的患者中,稳定性心绞痛比例明显多于不稳定性心绞痛和急性心肌梗死;C反应蛋白升高亚组,急性心肌梗死比例最高,稳定性心绞痛的比例最低;冠状动脉病变高积分组C反应蛋白水平明显高于低积分组(P=0.000)。多因素回归分析表明,高C反应蛋白是早发冠心病显著的独立危险因素(OR=10.41;95%CI:2.31～31.24;P=0.001)。结论:早发冠心病患者血浆C反应蛋白水平明显升高;高C反应蛋白与早发冠心病的临床表型和冠脉病变相关;高C反应蛋白是早发冠心病的独立危险因素。 Objective: To investigate the relationship between plasma C - reactive protein and clinical phenotype and coronary artery disease in patients with premature coronary heart disease, and to provide a theoretical basis for the intervention of early rehabilitation of coronary heart disease. Methods: Judkins method was used to make coronary angiography clearly premature coronary heart disease and normal control group. Diagnosis of coronary heart disease means that at least one coronary artery has a diameter reduction of ≥50% and is clinically diagnosed as having a myocardial infarction. Determination of plasma C - reactive protein by nephelometry. The clinical phenotype of premature coronary heart disease was divided into acute myocardial infarction, unstable angina pectoris and stable angina pectoris. According to the degree of coronary artery stenosis, the coronary artery lesion score was calculated. The case-control method was used for comparative study. Results: The level of plasma C-reactive protein in patients with PHA was significantly higher than that of the control group (3.2 ± 1.3) mg / L (7.5 ± 1.6) mg / L (P <0.01). In patients with normal C-reactive protein, the proportion of stable angina pectoris was significantly higher than that of unstable angina pectoris and acute myocardial infarction. The highest C-reactive protein subgroup had the highest proportion of acute myocardial infarction and the lowest proportion of stable angina pectoris. High-score group C-reactive protein levels were significantly higher than the low score group (P = 0.000). Multivariate regression analysis showed that high C-reactive protein was a significant independent risk factor for premature coronary heart disease (OR = 10.41; 95% CI: 2.31-31.24; P = 0.001). CONCLUSIONS: Plasma C-reactive protein levels are significantly elevated in patients with premature coronary heart disease. High C-reactive protein is associated with clinical phenotype and coronary artery disease in premature coronary heart disease. High-CRP is an independent risk factor for premature coronary heart disease.