论文部分内容阅读
目的 探讨基础血清C反应蛋白 (CRP)水平对冠状动脉支架置入术后 6个月内心血管事件和再狭窄的预测价值。方法 术前测定 78例单支病变的冠状动脉支架置入术患者 [2 8例稳定性心绞痛 (SAP)和 5 0例急性冠脉综合征 (ACS) ]基础血清CRP水平。将患者分为CRP <3 0mg/L(31例 )和CRP≥ 3 0mg/L (4 7例 )两组 ,分析并记录患者术后 1周以及术后 6个月内心血管事件 (心绞痛、心肌梗死及死亡 )发生率及支架内再狭窄 (血管内直径狭窄率≥ 5 0 % )等情况。结果 基础血清CRP水平在ACS组比稳定心绞痛组高 [(7 8± 2 6 )比 (2 8± 0 4 )mg/L ,P <0 0 1];术后 1周内的心血管事件发生率在ACS组、CRP升高组比稳定心绞痛、CRP不高组明显升高 (8%比 3 6 % ,P <0 0 5 ) ;术后6个月的心血管事件及支架内再狭窄发生率亦是CRP高者远高于CRP低者 (2 1 5 %比 7 7% ,P <0 0 1;19 5 %比 7 7% ,P <0 0 1)。结论 基础血清CRP水平是单支冠状动脉病变支架置入术后 6个月内预后的预测指标 ,这提示术后 6个月内心血管事件发生率和支架内再狭窄是和支架置入术前炎症细胞活化程度密切相关。
Objective To investigate the predictive value of basal serum C - reactive protein (CRP) level in cardiovascular events and restenosis within 6 months after coronary stenting. Methods Serum CRP levels were measured preoperatively in 78 patients with coronary artery disease undergoing stent implantation in 28 patients with coronary artery disease [28 patients with stable angina (SAP) and 50 patients with acute coronary syndrome]. The patients were divided into two groups: CRP <300mg / L (31 cases) and CRP≥30mg / L (47 cases). The patients’ cardiovascular events (angina pectoris and myocardium) were analyzed and recorded at 1 week and 6 months after operation Infarction and death) and in-stent restenosis (stenosis rate ≥ 50%) and so on. Results The basal serum CRP level was higher in patients with ACS than those in patients with stable angina [(7 8 ± 2 6) vs (2 8 ± 0 4) mg / L, P 0 01). Cardiovascular events occurred within 1 week after operation The rates of cardiovascular events and in-stent restenosis at 6 months after surgery in ACS group were significantly higher than those in stable angina and CRP group (8% vs. 36%, P <0 05) Rates were also higher in those with a higher CRP than those with a lower CRP (21.5% vs. 77%, P <0.01; 19.5% vs. 77%, P <0.01). Conclusions The baseline serum CRP level is a predictor of prognosis within 6 months after stent implantation in single coronary artery. This suggests that the incidence of cardiovascular events and in-stent restenosis within 6 months after surgery is similar to that before stenting The degree of cell activation is closely related.