经皮冠状动脉腔内成形术对冠心病患者血液C反应蛋白及肌钙蛋白T的影响(摘要)

中国循环杂志 1999年第0期第14卷 摘要　冠心病介入治疗

作者：刘海波　高润霖　陈纪林　杨跃进　秦学文　乔树宾　姚民　吴永健　宋杰　陈在嘉

单位：北京市，中国医学科学院　中国协和医科大学　心血管病研究所；阜外心血管病医院　冠心病研究室(100037)

　　目的：C反应蛋白（CRP）是一个敏感的炎症指标。近年的研究表明，CRP是冠心病发病的一个危险因素。本研究旨在评价经皮冠状动脉腔内成形术（PTCA）对血液CRP及肌钙蛋白T（TnT）的影响并探讨CRP与TnT的关系。

　　方法：选择1999年2月至4月在我院进行PTCA的患者为研究对象(n=48)，同时选择一组同期进行冠状动脉造影（CAA）的患者作为对照(n=30)。分别于PTCA或CAA术当天及术后第二天清晨采集空腹血进行血浆CRP及TnT水平的测定。

　　结果：PTCA的患者，PTCA术后血浆CRP水平显著高于术前（分别为4.65±0.73 mg/L对2.89±0.22 mg/L,P=0.017）；而PTCA术后血浆TnT水平与术前比较无显著差别（分别为0.038±0.015 ng/ml对0.016±0.007 ng/ml,P=0.21）。CAA的患者，造影后血浆CRP及TnT水平与造影前比较均无显著差别（分别为2.49±0.28 mg/L对2.79±0.27 mg/L,P=0.27,及0.027±0.020 ng/ml对0.018±0.011 ng/ml,P=0.49）。

　　结论：冠状动脉腔内成形术增加血液CRP水平。CRP的增加不是心肌坏死所引起，而可能是PTCA治疗局部炎性反应的一种表现。

Effects of Coronary Angioplasty on Blood Levels of C-Reactive Protein and Troponin T (Abstract)

Division of Coronary Heart Disease, Cardiovascular Institute and Fu Wai Hospital, CAMS and PUMC, Beijing (100037)

　　Liu Haibo, Gao Runlin, Chen Jilin, et al.

　　Objective: C-reactive protein (CRP) is a sensitive indicator of inflammation, and recent studies have showed that CRP is a risk factor in coronary heart disease. The aim of the study was to examine the effect of coronary angioplasty on blood levels of CRP and evaluate the association between blood CRP and troponin T (TnT).

　　Methods: Forty-eight patients who underwent coronary angioplasty from February to April, 1999, were included in this study, and 30 patients who received coronary angiography during the same period were selected as controls. Blood samples for measurement of CRP and TnT were taken in the early morning of the procedure and the followed early morning after the procedure.

　　Results: In patients with coronary angioplasty, CRP levels after the procedure were significantly higher than that before the procedure (4.65±0.73 mg/L vs. 2.89±0.22 mg/L, p=0.017), but the blood levels of TnT after the procedure were not significantly higher than that before the procedure (0.038±0.015 ng/ml vs. 0.016±0.007 ng/ml, p=0.21). In control group, both CRP and TnT levels after angiography were not significantly higher than those before angiography (2.49±0.28 mg/L vs. 2.79±0.27 mg/L, p=0.27, and 0.027±0.020 ng/ml vs. 0.018±0.011 ng/ml, p=0.49, respectively).

　　Conclusion: Coronary angioplasty leads to a detectable increase in blood levels of C-reactive protein. The increase might not be secondary to myocardial injury, but simply reflects the intrinsic inflammation or tissue damage within the arterial lesions treated with angioplasty.