Fang Lu, Wei Heming, Mak Koon Hou, Xiong Zhuowei, Song Jie, Wang Dong, Lim Yean Leng, Chatterjee Subroto
Johns Hopkins Singapore-National Heart Centre Vascular Biology Program, National Heart Centre of Singapore, Singapore.
Can J Cardiol. 2004 Dec;20(14):1433-8.
Inflammation plays an important role in atherosclerosis. Markers of low-grade chronic inflammation, such as C-reactive protein (CRP) and soluble cell adhesion molecules (sCAMs), have been associated with coronary artery disease (CAD).
To evaluate the significance of inflammatory markers as novel risk factors for CAD in the Chinese population.
High-sensitivity CRP (hs-CRP); sCAMs, including vascular cell adhesion molecule-1 (sVCAM-1), intercellular cell adhesion molecule-1 (sICAM-1), P-selectin (sP-selectin) and E-selectin (sE-selectin); and white blood cell (WBC) count were measured in 170 angiographically defined CAD patients (70% or greater stenosis affecting at least one vessel) and 177 healthy control subjects in the Chinese population in Singapore.
The levels of hs-CRP, sVCAM-1 and sP-selectin, and the WBC count were higher in CAD patients than in control subjects (P<0.001, P<0.05, P<0.05 and P<0.001, respectively). There were no significant differences in the levels of sICAM-1 and sE-selectin between the two groups. Patients with unstable angina or myocardial infarction had higher levels of hs-CRP, and higher WBC and monocyte counts than those with stable angina or atypical chest pain (all P<0.05). The level of sP-selectin in patients with multivessel disease was higher than in those with single-vessel disease (P<0.05). Overall, the levels of hs-CRP and sCAMs showed a significant correlation with the lipid profile and the WBC count.
The present study suggests that inflammatory markers, including hs-CRP and WBC count, together with sP-selectin and sVCAM-1, could serve as markers of atherogenesis in Chinese patients with CAD, with potential diagnostic and therapeutic implications.
炎症在动脉粥样硬化中起重要作用。低级别慢性炎症标志物，如C反应蛋白（CRP）和可溶性细胞粘附分子（sCAMs），已与冠状动脉疾病（CAD）相关联。
评估炎症标志物作为中国人群CAD新危险因素的意义。
在新加坡的中国人群中，对170例经血管造影确诊的CAD患者（至少一支血管狭窄达70%或更高）和177例健康对照者测量高敏CRP（hs-CRP）；sCAMs，包括血管细胞粘附分子-1（sVCAM-1）、细胞间细胞粘附分子-1（sICAM-1）、P-选择素（sP-选择素）和E-选择素（sE-选择素）；以及白细胞（WBC）计数。
CAD患者的hs-CRP、sVCAM-1和sP-选择素水平以及WBC计数均高于对照者（分别为P<0.001、P<0.05、P<0.05和P<0.001）。两组间sICAM-1和sE-选择素水平无显著差异。不稳定型心绞痛或心肌梗死患者的hs-CRP水平、WBC和单核细胞计数高于稳定型心绞痛或非典型胸痛患者（均P<0.05）。多支血管病变患者的sP-选择素水平高于单支血管病变患者（P<0.05）。总体而言，hs-CRP和sCAMs水平与血脂谱及WBC计数显著相关。
本研究表明，包括hs-CRP和WBC计数以及sP-选择素和sVCAM-1在内的炎症标志物可作为中国CAD患者动脉粥样硬化形成的标志物，具有潜在的诊断和治疗意义。
