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目的:探讨不同类型心绞痛患者支架术前后血浆C反应蛋白(CRP)浓度的变化及其意义。方法:选择51例进行支架术的患者[支架术组,其中稳定型心绞痛(SA)13例,不稳定型心绞痛(UA)38例]作为研究对象,同时选择同期仅进行冠状动脉造影的18例心绞痛患者为对照组。2组患者分别于支架术、冠状动脉造影前当天早晨、术后48h采静脉血进行血浆CRP测定。结果:术前,SA者与对照组比较CRP水平差异无统计学意义,UA中BraunwaldⅡ级(14例)、Ⅲ级(13例)者与SA者、对照组比较CRP水平均有显著性升高[(6.23±1.24)、(6.45±0.91)mg/L∶(3.91±0.96)、(4.25±0.84)mg/L,均P<0.05],但UA各级间CRP差异无统计学意义;术后,对照组CRP浓度与术前比较差异无统计学意义,但支架术组SA者、UA各级者CRP均显著升高,且随UA临床分级增加CRP升高越显著[SA者,UAⅠ、Ⅱ、Ⅲ级者CRP分别为(6.03±0.81)、(10.73±1.02)、(14.35±2.38)、(24.40±4.21)mg/L]。支架术组术后CRP浓度与术前CRP浓度无显著直线相关(r=0.32,P>0.05)。结论:冠状动脉支架术增加不同类型心绞痛患者血浆CRP水平;UA临床分级越高,术后CRP水平升高越明显,CPR水平可作为冠状动脉病变不稳定性的预测指标。
Objective: To investigate the changes of plasma C-reactive protein (CRP) levels and their significance before and after stent implantation in patients with different types of angina pectoris. Methods: Totally 51 patients who underwent stenting (Stenting group, 13 cases of stable angina pectoris (SA) and 38 cases of unstable angina pectoris (UA)] were selected as the study subjects. At the same time, 18 cases undergoing coronary angiography Angina patients as control group. Two groups of patients were respectively screened for coronary artery angiography, coronary angiography, and venous blood 48 h after surgery. Results: There was no significant difference in CRP levels between SA group and control group before operation. The levels of CRP in Braunwald stage Ⅱ (14 cases) and Ⅲ stage (13 cases) in UA group were significantly higher than those in control group (6.23 ± 1.24) and (6.45 ± 0.91) mg / L respectively (3.91 ± 0.96) and (4.25 ± 0.84) mg / L, all P <0.05]. However, there was no significant difference in CRP between different grades of UA However, there was no significant difference in the CRP concentration between the control group and the preoperative level, but there was a significant increase in the CRP levels in the SA group and the UA group in the stent group, and the more significant CRP increase with the clinical classification of UA [SA, UAⅠ, The CRP of grade Ⅱ and Ⅲ were (6.03 ± 0.81), (10.73 ± 1.02), (14.35 ± 2.38) and (24.40 ± 4.21) mg / L, respectively. There was no significant linear correlation between postoperative CRP concentration and preoperative CRP concentration in the stent group (r = 0.32, P> 0.05). Conclusion: Coronary stenting increases plasma CRP levels in patients with different types of angina pectoris. The higher the clinical grade of UA, the more obvious the CRP level rises after surgery, and the CPR level can be used as a predictor of coronary artery disease instability.