冠状动脉病变与颈动脉斑块及 C 反应蛋白水平的关系

摘要

目的：探讨冠心病患者冠状动脉病变与颈动脉内膜中层厚度（IMT ）和斑块积分以及血浆 C反应蛋白（CRP）水平的关系。方法：选择冠心病患者（83例，冠心病组）与非冠心病患者（37例，非冠心病组），对冠心病患者进行冠脉造影，根据冠脉病变血管数冠心病患者又被分为：单支病变组（28例）、双支病变组（31例）及三支病变组（24例）。检测各组患者C反应蛋白（CRP）水平，颈动脉内膜中层厚度（IMT），并对颈动脉粥样硬化斑块进行分级。结果：与非冠心病组比较，冠心病组患者CRP水平[（0.89±0.54） mg／L比（3.50±3.42） mg／L]、IMT [（0.65±0.27） mm比（1.04±0.31） mm]明显增加（P＜0.05或＜0.01）；与单支病变组和双支病变组比较，三支病变组的CRP水平[（1.44±1.03） mg／L ，（3.71±3.52） mg／L比（5.82±3.98） mg／L]显著升高，颈动脉斑块3级比例（0％、0％比25％）显著升高（ P均＜0.01）。结论：冠心病患者C反应蛋白水平及颈动脉内膜中层厚度明显增加，且多支病变者C反应蛋白水平及颈动脉粥样硬化斑块3级比例明显增加。%Objective:To explore the relationship among carotid intima‐media thickness (IMT) ,plaque score ,plasma level of C reactive protein (CRP) and coronary artery lesion in patients with coronary heart disease (CHD) .Meth‐ods:A total of 83 CHD patients were enrolled as CHD group and 37 patients without CHD were enrolled as non‐CHD group .CHD patients received coronary angiography .According to number of diseased coronary vessels ,CHD patients were divided into single vessel coronary disease group (n=28 ,single vessel group ) ,double‐vessel coronary disease group (n=31 ,double‐vessel group) and triple‐vessel coronary disease group (n= 24 ,triple‐vessel group) . Plasma CRP level and carotid IMT were measured ,and carotid atherosclerotic plaques were classified in all groups . Results :Compared with non‐CHD group ,there were significant rise in CRP level [ (0.89 ± 0.54) mg/L vs . (3.50 ± 3.42) mg/L] and IMT [ (0.65 ± 0.27) mm vs . (1.04 ± 0.31) mm] in CHD group (P<0.05 or <0.01);Com‐pared with single‐vessel group and double‐vessel group ,the CRP level of triple‐vessel group [ (1.44 ± 1.03) mg/L , (3.71 ± 3.52) mg/L vs .5.82 ± 3.98) mg/L] significantly rose ;the percentage of carotid plaque class 3 of triple‐ves‐sel group (0% 、0% vs .25% ) significantly rose (P<0.01 all) .Conclusion:C reactive protein level and carotid intima‐media thickness significantly rise in patients with coronary heart disease ,and there are significant rise in C reactive protein level and percentage of carotid atherosclerotic plaque class 3 in patients with multi‐vessel coronary disease .