Gölbasi Zehra, Uçar Ozgül, Keles Telat, Sahin Ahmet, Cagli Kerim, Camsari Ahmet, Diker Erdem, Aydogdu Sinan
Department of Cardiology, Ankara Numune Education and Research Hospital, Yuva sok No 20/2, Küçükesat 06660, Ankara, Turkey.
Eur J Heart Fail. 2002 Oct;4(5):593-5. doi: 10.1016/s1388-9842(02)00102-2.
The precise pathogenetic mechanism(s) of rheumatic fever and rheumatic heart disease have never been defined. C-reactive protein (CRP) is increased in patients with acute rheumatic fever, but it is not known whether plasma levels increase in patients with chronic rheumatic valve disease. The aim of this study was to determine the role of inflammation detected by high sensitivity CRP (hs-CRP) levels in the progression of chronic rheumatic valve disease. A total of 113 patients with chronic rheumatic valve disease (81 women, 32 men; mean age 40+/-14 years, range 13-70), 51 patients with prosthetic valve(s) (31 women, 20 men; mean age 48+/-13 years, range 21-71) and 102 healthy subjects (68 women, 34 men, mean age 41+/-12 years, range 25-73), as a control group, were assessed. Patients with acute rheumatic fever, acute infection, inflammatory disease, malignancy, acute myocardial infarction and trauma were excluded. hs-CRP was determined using latex-enhanced immunonephelometric assays on a BN II analyzer (Behring). Transthoracic echocardiography was performed in all patients in order to evaluate valvular disease. Levels of hs-CRP were significantly higher in patients with chronic rheumatic heart disease than in patients with prosthetic valve(s) and healthy subjects (0.62+/-0.64 vs. 0.35+/-0.41 vs. 0.24+/-0.18 mg/l, P<0.01 and P<0.001 respectively). No correlation was observed between CRP and age, sex or functional capacity. We found that hs-CRP is increased in chronic rheumatic heart disease; this may indicate that inflammatory response still persists in the chronic phase.
风湿热和风湿性心脏病确切的发病机制尚未明确。急性风湿热患者的C反应蛋白（CRP）水平会升高，但慢性风湿性瓣膜病患者的血浆水平是否升高尚不清楚。本研究的目的是确定通过高敏CRP（hs-CRP）水平检测到的炎症在慢性风湿性瓣膜病进展中的作用。共有113例慢性风湿性瓣膜病患者（81例女性，32例男性；平均年龄40±14岁，范围13 - 70岁）、51例人工瓣膜置换患者（31例女性，20例男性；平均年龄48±13岁，范围21 - 71岁）和102名健康受试者（68例女性，34例男性，平均年龄41±12岁，范围25 - 73岁）作为对照组接受评估。排除患有急性风湿热、急性感染、炎症性疾病、恶性肿瘤、急性心肌梗死和创伤的患者。使用BN II分析仪（拜耳）上的乳胶增强免疫比浊法测定hs-CRP。对所有患者进行经胸超声心动图检查以评估瓣膜疾病。慢性风湿性心脏病患者的hs-CRP水平显著高于人工瓣膜置换患者和健康受试者（分别为0.62±0.64 vs. 0.35±0.41 vs. 0.24±0.18 mg/l，P<0.01和P<0.001）。未观察到CRP与年龄、性别或功能能力之间存在相关性。我们发现慢性风湿性心脏病患者的hs-CRP升高；这可能表明炎症反应在慢性期仍持续存在。
