ELEVATION OF C-REACTIVE PROTEIN IN ACTIVE CORONARY-ARTERY DISEASE
ELEVATION OF C-REACTIVE PROTEIN IN ACTIVE CORONARY-ARTERY DISEASE
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DOI：
10.1016/0002-9149(90)90079-g
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发表时间：
1990-01-15
影响因子：
2.8
通讯作者：
ALEXANDER, RW
中科院分区：
文献类型：
--
作者：
BERK, BC;WEINTRAUB, WS;ALEXANDER, RW
不稳定型心绞痛最常发生在动脉粥样硬化性冠状动脉疾病(CAD)的环境中，但关于冠状动脉斑块从临床稳定到不稳定的机制鲜有报道。近年来，不稳定型心绞痛患者冠状动脉外膜局部炎性细胞浸润增多，不稳定型心绞痛患者中性粒细胞活化。为了表征“活动性”动脉粥样硬化病变的炎症压力，测定了37例不稳定型心绞痛患者、30例非缺血性疾病患者和32例稳定型冠心病患者的急性期反应性C-反应蛋白(CRP)水平。结果表明，90%的不稳定型心绞痛组CRP水平显著升高(0.6 mg/dl)，而冠脉监护病房组和稳定型心绞痛组的CRP水平分别为20%和13%。不稳定型心绞痛组的CRP值平均值(2.2.+-)有显著差异(p=0.001)。2.9 mg/dl)，而冠状动脉护理组(0.9±-)。0.7 mg/dl)和稳定型心绞痛(0.7±-)。0.2 mg/dl)组。有缺血性ST-T波异常的不稳定型心绞痛患者有较高的CRP值的趋势(2.6.+-。3.4)，而无心电图改变者(1.3±-)。0.9，p=0.1)。数据显示，在不稳定型心绞痛中，急性期反应物水平升高。这些发现表明，“活动性”心绞痛中的一种炎症成分可能有助于这些患者对血管痉挛和血栓的易感性。
Unstable angina occurs most commonly in the setting of atherosclerotic coronary artery disease (CAD), but there is little information concerning the mechanisms responsible for the transition from clinically stable to unstable coronary atherosclerotic plaque. Recently, increased focal infiltration of inflammatory cells into the adventitia of coronary arteries of patients dying suddenly from CAD and activatin of circulating neutrophils in patients with unstable angina have been observed. To characterize the pressure of inflammation in "active" atherosclerotic lesions, the acute phase reactant C-reactive protein (CRP) was measured in 37 patients admitted to the coronary care unit with unstable angina, 30 patients admitted to the coronary care unit with nonischemic illnesses and 32 patients with stable CAD, CRP levels were significantly elevated (normal < 0.6 mg/dl) in 90% of the unstable angina group compared to 20% of the coronary care unit group and 13% of the stable angina group. The average CRP values were significantly different (p = 0.001) for the unstable angina group (2.2 .+-. 2.9 mg/dl) compared to the coronary care (0.9 .+-. 0.7 mg/dl) and stable angina (0.7 .+-. 0.2 mg/dl) groups. There was a trend for unstable angina patients with ischemic ST-T wave abnormalities to have higher CRP values (2.6 .+-. 3.4) than those without electrocardiographic changes (1.3 .+-. 0.9, p = 0.1). The data demonstrate increased levels of an acute phase reactant in unstable angina. These findings suggest that an inflammatory component in "active" angina may contribute to the susceptibility of these patients to vasospasm and thrombosis.