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目的探讨冠心病患者超敏C-反应蛋白(hsCRP)与颈动脉内膜中层厚度(cIMT)和斑块积分的相关性。方法采用高分辨率血管超声法检测88例冠心病患者与30例正常对照组患者颈动脉IMT及斑块积分,冠心病患者根据颈动脉粥样硬化斑块的超声分级分为无斑块组、1级斑块组、2级斑块组和3级斑块组。并检测88例冠心病患者与30例正常对照组患者血液中hsCRP。并对冠心病患者进行冠脉造影,左主干、左前降支、左回旋支及右冠状动脉四根血管中任何一根血管狭窄≥50%即诊断为冠心病。结果冠心病患者的血浆hsCRP水平及颈动脉IMT显著高于对照组,P<0.05;血浆hsCRP水平在冠心病各亚组间比较差异有显著性,P<0.05;而cIMT在冠心病各亚组间比较差异无显著性,P>0.05。对照组中无一例患者出现颈动脉斑块。冠心病患者血浆hsCRP水平与颈动脉斑块积分存在正相关,相关系数分别为0.754,P<0.05;冠心病患者血浆hsCRP水平与cIMT无相关性。结论通过检测血浆hsCRP水平可反映颈动脉动脉粥样硬化的严重程度。
Objective To investigate the correlation between hsCRP and carotid intima-media thickness (cIMT) and plaque score in patients with coronary heart disease. Methods The IMT and plaque score of carotid artery in 88 patients with coronary heart disease and 30 normal controls were measured by high resolution ultrasound. The patients with coronary heart disease were divided into no plaque group according to the ultrasound grading of carotid atherosclerosis plaque, 1 plaque group, 2 plaque group and 3 plaque group. Blood hsCRP was measured in 88 patients with CHD and 30 normal controls. Coronary angiography and left coronary artery, left anterior descending branch, left circumflex artery and right coronary artery in any one of four vascular stenosis ≥ 50% that is diagnosed as coronary heart disease. Results The plasma levels of hsCRP and carotid artery IMT in patients with coronary heart disease were significantly higher than those in the control group (P <0.05). There was a significant difference in plasma hsCRP levels among all subgroups of coronary heart disease (P <0.05) There was no significant difference between the two groups (P> 0.05). None of the patients in the control group developed carotid plaques. There was a positive correlation between plasma hsCRP levels and carotid artery plaque score in coronary heart disease patients, the correlation coefficients were 0.754, P <0.05 respectively. There was no correlation between plasma hsCRP levels and cIMT in patients with coronary heart disease. Conclusions The severity of carotid artery atherosclerosis can be measured by measuring plasma hsCRP level.