超敏C反应蛋白在冠心病中的临床应用

目的测定冠心病患者（CHD）血清超敏C反应蛋白（hs—CRP）水平，探讨其在CHD的发病及病情监测中的作用。方法经冠脉造影证实的CHD患者98例，采用胶乳增强免疫比浊法，定量检测血清中hs—CRP水平。并对其中43例CHD患者检测治疗后hs—CRP水平，并比较治疗前后hs—CRP的含量变化。结果CHD患者血清hs—CRP水平（8．25±6．38）较正常对照组（1．93±0．77）显著增高（P〈0．001）；其中心肌梗死（AMI）组（13．93±5．81）和不稳定型心绞痛（UAP）组（9．42±5．25）的hs—CRP水平明显高于稳定型心绞痛（sAP）组（3．57±3．10）（P〈0．01）；AMI组血清hs—CRP水平与UAP组差异也有显著性（P〈0．01）；除SAP组外，其中36例CHD患者治疗前后的hs—CRP水平差异亦有显著性（P〈0．05）。结论从SAP到AMI的过程中，hs—CRP水平有逐渐增加的趋势，说明hs—CRP水平与CHD的发生、发展和预后密切相关，可作为CHD的早期诊断和病情监测的指标，值得临床推广。

Clinical application of hypersensitive C - reactive protein in treatment of coronary heart disease

Objective To explore the clinical significance and evaluate the feasibility of using high sensitivity C - reactive protein （hs - CRP） in treatment of patients with coronary heart disease （CHD）. Methods Ninety - eight 98 CHD patients diagnosed by coronary angiography were divided into three groups including SAP group consisted of 42 patients with stable angina （SAP）, UAP group consisted of 27 patients with unstable angina （UAP） and AMI group consisted of 29 patients with acute myocardial infarction （ AMI ） ; 52 healthy persons were enrolled in normal control group. The levels of hs - CRP in sera of patients of 4 groups were determined by enhanced immunoturbidimetry and analyzed. In addition, the level of hs - CRP in 43 CHD patients before and after the treatment were determined and compared. Results The level of hs - CRP in sera of CHD patients （8.25 ± 6.38） was significantly higher than that of the normal control group （1.93 ± 0.77）（ P 〈 0. 001 ） ;the levels of hs - CRP in AMI group（ 13.93 ± 5.81 ） and UAP（9.42 ± 5.25） group were significantly higher than that in SAP group （3.57 ± 3.10） （ P 〈 0.01） ; and the level of hs - CRP in AMI group also significantly higher than that in UAP group （ P 〈 0.01） ; excluded those in SAP group, the level of hs - CRP in 36 CHD patients was significantly different before and after treatment （P 〈 0.05）. Conclusion From SAP to AMI, the levels of hs - CRP increased significantly, close correlation was identified between hs - CRP level and severity of CHD. The high level of hs - CRP is an early prognostic indicator for patients with CHD, and it is the available predictor and indicator for monitoring CHD.