冠脉成形术后炎症反应及其临床意义

目的 观察经皮冠状动脉腔内成形术(PTCA) 后血清炎症标志物C 反应蛋白(CRP) 的变化, 并研究术后CRP 浓度与远期临床疗效的联系。方法 不稳定型心绞痛(UA) 患者47 例, 用放射免疫法分别测定PTCA 术前、术后48 h 及术后1 w k 血清CRP,随访9 mon 内临床再狭窄发生率, 比较再狭窄组与无再狭窄之间血清CRP 值。25 例冠脉造影(CAG)术前、术后48 h 的血清CRP 作为对照。结果 PTCA术后48 h CRP 较术前显著升高(P<0.01), 而术后1 wk CRP 值和术前无差异, CAG 术前、术后的CRP 无显著变化。随访期间有13 例患者诊断为临床再狭窄, 其术后48 h CRP 较非再狭窄组显著增高(P<0.01)。结论 PTCA 术后48 h 血清CRP 较术前显著增高, 与PTCA 术后远期临床疗效密切相关。

Prognostic value of elevated C-reactive protein in unstable angina after percutaneous transluminal coronary angioplasty

Aim To observe the changes of serum C-reactive protein (CRP) in patient s with unstable angina after percutaneous transluminal coronary angioplasty (PTCA) and to invetstig ate the relationship between the peak values of CRP and clinical restenosis.Methods A prospective case study was undertaken in 47 patients who underwent successful PTCA (PTCA group) for unstable angina and another 25 patients as control who underwent coronary angiog raphy.Levels of CRP were measured by RIA at baseline, 48 hours and one week after PTCA.All of PTCA group were followed clinically for 9 months.An exercise testing or a thallium perfusion scan (TPS) was performed within nine months post-PTCA and CAG was repeated in the part of abnormal patient s.Results At nine-month follow-up, clinical restenosis developed in 44% of 25 patients with high serum levels (>30 mg·L^-1) of CRP, and in 9.1% of 22 patient s with normal CRP levels(P<0.01).Conclusion Serum CRP 48 hours after PTCA is a marker of ninemonth clinical performance.