Wilson Andrew M, Ryan Marno C, Boyle Andrew J
University of Melbourne, Department of Medicine, St Vincent's Hospital, Princes St., Fitzroy, Melbourne, Victoria 3065, Australia.
Int J Cardiol. 2006 Jan 26;106(3):291-7. doi: 10.1016/j.ijcard.2005.01.068.
C-reactive protein (CRP) is a non-specific biomarker of inflammation. Recent research has shown that inflammation is an important step in the genesis of atherosclerosis, and is involved in the development of unstable plaques. Measurement of serum levels of CRP using a high sensitivity assay (hsCRP) can demonstrate subclinical inflammatory states, which may reflect vascular inflammation. Clinical studies have shown that elevated hsCRP levels in healthy populations predict vascular events such as myocardial infarction (MI) and stroke as well as the development of diabetes. In patients with acute coronary syndromes, higher hsCRP levels are associated with adverse outcomes and subsequent vascular events. There is data to suggest that aspirin, angiotensin converting enzyme (ACE) inhibitors and HMG Co-A reductase inhibitors (statins), which all reduce vascular event rates, also reduce serum levels of hsCRP and therefore hsCRP levels may potentially guide therapy. As well as having a critical role in risk prediction, recent evidence has emerged implicating CRP directly in atherogenesis. CRP has been found in human atherosclerotic plaque and CRP has been shown to cause endothelial cell dysfunction, oxidant stress and intimal hypertrophy in experimental models. We review the postulated roles of CRP in atherogenesis and prediction of vascular events, as well as discussing current recommendations for CRP testing in patients.
C反应蛋白（CRP）是一种非特异性炎症生物标志物。最近的研究表明，炎症是动脉粥样硬化发生过程中的一个重要步骤，并参与不稳定斑块的形成。使用高敏检测法（hsCRP）测量血清CRP水平可显示亚临床炎症状态，这可能反映血管炎症。临床研究表明，健康人群中hsCRP水平升高可预测心肌梗死（MI）和中风等血管事件以及糖尿病的发生。在急性冠脉综合征患者中，较高的hsCRP水平与不良预后及随后的血管事件相关。有数据表明，阿司匹林、血管紧张素转换酶（ACE）抑制剂和HMG Co-A还原酶抑制剂（他汀类药物）均可降低血管事件发生率，它们还可降低血清hsCRP水平，因此hsCRP水平可能有助于指导治疗。除了在风险预测中起关键作用外，最近有证据表明CRP直接参与动脉粥样硬化的发生。CRP已在人类动脉粥样硬化斑块中被发现，并且在实验模型中已表明CRP可导致内皮细胞功能障碍、氧化应激和内膜肥厚。我们综述了CRP在动脉粥样硬化发生及血管事件预测中的假定作用，并讨论了目前针对患者CRP检测的建议。
