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目的 探讨冠心病患者介入治疗前后血清C -反应蛋白 (CRP)水平变化与术后住院期间及术后 6个月内心血管事件和再狭窄发生的关系。方法 选择 97例住院接受经皮冠状动脉腔内成形术 (PTCA)及单支病变的冠状动脉支架置入术 (CS)冠心病患者 [其中 30例稳定型心绞痛 (SAP)和 6 7例急性冠脉综合征 (ACS) ]术前及术后 4 8h测定血清CRP水平。按术后CRP水平分为 2组 ,即A组 (CRP水平 <3.0mg L ,n =35 )及B组 (CRP水平≥ 3.0mg L ,n =6 2 ) ,分析并记录患者术后 1周以及术后 6个月内心血管事件及支架内再狭窄发生等情况。结果 ACS组PT CA术后 4 8h血清CRP水平较术前明显升高 (P <0 .0 1) ;血清CRP水平ACS组比SAP组明显升高 (P <0 .0 1) ;B组术后 1周内的心血管事件发生率显著高于A组 (P <0 .0 5 ) ;B组术后 6个月的心血管事件及支架内再狭窄发生率显著大于A组 (P <0 .0 1)。结论 PTCA术后 4 8h血清CRP水平较术前增高 ,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 ,提示术后近、远期的临床疗效与支架置入术后血管壁的炎症反应增强有关。
Objective To investigate the changes of serum C - reactive protein (CRP) level before and after interventional therapy in patients with coronary heart disease (CHD) before and after hospitalization and the incidence of cardiovascular events and restenosis within 6 months after operation. Methods Ninety-seven patients with coronary artery disease undergoing coronary stenting (CS) admitted to hospital for percutaneous transluminal coronary angioplasty (PTCA) and one-vessel disease (30 patients with stable angina pectoris (SAP) and 67 acute crowns Pulse syndrome (ACS)] serum CRP levels were measured before and after 48 h. The patients were divided into two groups according to their postoperative CRP levels: group A (CRP level <3.0 mg L, n = 35) and group B (CRP level ≥ 3.0 mg L, n = 62) As well as cardiovascular events and in-stent restenosis within 6 months after surgery. Results Serum CRP levels were significantly increased at 48 h after PT CA in ACS group (P <0.01), serum CRP level was significantly higher in ACS group than in SAP group (P <0.01) The incidence of cardiovascular events within 1 week was significantly higher than that of group A (P <0.05). The incidence of cardiovascular events and in-stent restenosis at 6 months after operation in group B was significantly higher than that in group A (P <0 .0 1). Conclusions Serum CRP level increased 48 h after PTCA compared with that before operation, which is a predictor of prognosis within 6 months after single coronary artery stent implantation, suggesting that the clinical efficacy of near and long-term postoperative PTCA Inflammatory response to vascular wall enhancement.