摘要
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 whether the cardiovascular events and restenosis in in-hospital course and in 6 months after coronary stent implantation could be predicted by serum levels of C-reactive protein(CRP). Methods Preprocedural serum levels of CRP were measured in 97 cases [stable angina pectoris(SAP)n=30,acute coronary syndrome(ACS) n=67]of single coronary stenting implantation before and 48h after operation. According to the level of CRP after PTCA operation, the patients were divided into two groups: group A(CRP<3.0mg/L,n=35=and group B(CRP≥3.0mg/L,n=62).The cardiovascular event and stent restenosis were carefully observed and recorded intraprocedural in 1 week and 6 months after the procedures. Results The mean CRP level at 48h after PTCA operation was significantly higher in ACS group than that before operation(P<0.01);the serum levels of CRP were significantly higher in ACS group than that in SAP group(P<0.01).The frequency of cardiovascular event was significantly higher in B group than that in A group in 1 week(intraprocedural and inhospital)(P<0.05).The cardiovascular event and those in instent restencsis were significantly higher in B group than that in A group in 6 months(P<0.01). Conclusion Serum CRP level at 48h after PTCA operation is significantly higher than that before operation and it may be a predictor in 6 month outcome of patients undergoing single coronary stent implantation. It indicates that the complications and clinical restenosis in 6 months are markedly influenced by the preprocedual degree of inflammatory cell activation.
出处
《中国心血管病研究》
CAS
2004年第12期932-935,共4页
Chinese Journal of Cardiovascular Research
