经皮冠状脉介入术血清C反应蛋白的变化.docVIP

医学论文免费下载 经皮冠状动脉介入术血清C反应蛋白的变化 　　作者：李志勇1, 李 勋2*, 王生仁1 作者单位：(1汉中市3201医院心内科,陕西 汉中 723000;2苏州大学附属第一人民医院心内科,江苏 苏州 215006) 　　【摘要】 目的:探讨经皮冠状动脉介入治疗术(PCI)后患者血清C反应蛋白(CRP)的变化。方法:随机选取行PCI的冠心病患者76例，分别于术前5 min、术后48 h、1月及6月测定血清CRP水平。结果:PCI术后48 h CRP水平明显高于术前5 min，有显著性差异(P0.01);术后1月CRP水平较术前5 min明显下降(P0.05)。结论:PCI术可能在短期内触发并加重冠状动脉炎症，术后1月恢复正常;术后CRP水平持续或再次升高，提示患者病情不稳定。 　　【关键词】 冠心病;经皮冠状动脉介入治疗术; C反应蛋白 　　Changes of C Reactive Protein Level in Patients with Coronary Heart Disease after Percutaneous Coronary Intervention LI Zhi-yong1,LI Xun2,WANG Sheng-ren1 (Department of Cardiology,13201 Hospital,Hanzhong,Shanxi 723000;2First Affiliated Hospital,Suzhou University,Suzhou,Jiangsu 215006,China) 　　Abstract Objective: To observe the change of C reactive protein(CRP) level after percutaneous coronary intervention(PCI) and to explore the relationship between CRP and clinical state in patients with coronary heart disease(CHD).Method Seventy-six patients with CHD were treated with PCI.The serum levels of CRP were measured by ELISA at 5 min before PCI,and the 48th hour,the first mouth,the sixth mouth after PCI.Results The serum level of CRP at the 48th hour after PCI was higher than that before PCI (P0.01),and the CRP level at the first mouth after PCI was lower than that before PCI(P0.05).However,the CRP level at the sixth month after PCI was higher than that before PCI(P0.05).Conclusions PCI is likely to trigger and aggravate coronary artery inflammation in short-term and this change recovers to normal at the first month after PCI.The lesion in CHD may be unstable if the serum level of CRP continuously increases or elevates again. 　　Key words: Coronary heart disease;Percutaneous coronary intervention;C reactive protein 　　C反应蛋白(C reactive protein，CRP)是典型的急性相蛋白，感染和组织损伤激活巨噬细胞和其他白细胞产生IL-6、IL-1等细胞因子，促使肝细胞产生急性期炎性反应物，使血液中的CRP升高[1]，故CRP几乎恒定不变地显示炎症的存在。 　　近年来的研究发现,动脉粥样硬化是一种慢性炎症性疾病[2],而动脉粥样硬化是冠心病(Coronary heart disease，CHD)的病理基础。经皮冠状动脉介入术(Percutaneous coronary intervention，PCI)球囊扩张及支架植入均有不同