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高敏C反应蛋白与钙化性主动脉瓣疾病的相关性

Correlation of high sensitivity C-reactive protein and calcific aortic valve disease.

作者信息

Jeevanantham Vinodh, Singh Natasha, Izuora Kenneth, D'Souza John P, Hsi David H

机构信息

Department of Medicine Park Ridge Hospital, Rochester, NY, USA.

出版信息

Mayo Clin Proc. 2007 Feb;82(2):171-4. doi: 10.4065/82.2.171.

Abstract

OBJECTIVE

To determine whether a difference exists in the levels of high sensitivity C-reactive protein (Hs-CRP) in patients with and without calcific aortic valve disease (CAVD).

PATIENTS AND METHODS

This cross-sectional study consisted of 110 patients who had undergone echocardiographic examination from January 2005 to February 2006 at our institution. Information on demographic variables, coronary risk factors, and medications was obtained. More than 200 patients were excluded on the basis of any evidence of infection, active connective tissue disorder, rheumatoid arthritis, recent episodes of bleeding, acute fractures, bowel obstruction, or acute coronary syndrome or use of corticosteroids, nonsteroidal anti-inflammatory drugs, or antibiotic treatment. The values of Hs-CRP, total cholesterol, and erythrocyte sedimentation rate were included.

RESULTS

Of the 110 study subjects, 38 patients had aortic sclerosis, 36 patients had aortic stenosis, and 36 were controls. The mean Hs-CRP level in the control group was significantly lower (4.84 +/- 6.9 mg/L) compared with the levels in the groups with aortic sclerosis (14.9 +/- 19.6 mg/L) and aortic stenosis (13.6 +/- 17.3 mg/L) (P = -.01). No statistically significant difference was found between the patients in the aortic sclerosis and aortic stenosis groups. Among the patients with aortic stenosis, no significant correlation existed between Hs-CRP levels and aortic stenosis severity.

CONCLUSIONS

The Hs-CRP seems to have a significant association with CAVD during its early stage. The study findings did not have sufficient evidence to suggest the use of Hs-CRP as a marker of progression of calcific aortic stenosis. The Hs-CRP may have a role in identifying patients in the early stages of CAVD and in whom medical treatment may be beneficial to halt the progression to irreversible aortic valvular calcification and stenosis.

摘要

目的

确定有和没有钙化性主动脉瓣疾病(CAVD)的患者中,高敏C反应蛋白(Hs-CRP)水平是否存在差异。

患者与方法

这项横断面研究纳入了2005年1月至2006年2月在我院接受超声心动图检查的110例患者。收集了人口统计学变量、冠状动脉危险因素和用药情况等信息。根据任何感染证据、活动性结缔组织病、类风湿关节炎、近期出血发作、急性骨折、肠梗阻或急性冠状动脉综合征,或使用皮质类固醇、非甾体抗炎药或抗生素治疗等情况,排除了200多名患者。纳入了Hs-CRP、总胆固醇和红细胞沉降率的值。

结果

在110名研究对象中,38例有主动脉硬化,36例有主动脉狭窄,36例为对照组。与主动脉硬化组(14.9±19.6mg/L)和主动脉狭窄组(13.6±17.3mg/L)相比,对照组的平均Hs-CRP水平显著更低(4.84±6.9mg/L)(P = -0.01)。主动脉硬化组和主动脉狭窄组患者之间未发现统计学上的显著差异。在主动脉狭窄患者中,Hs-CRP水平与主动脉狭窄严重程度之间无显著相关性。

结论

Hs-CRP似乎在CAVD早期与之有显著关联。研究结果没有足够证据表明可将Hs-CRP用作钙化性主动脉狭窄进展的标志物。Hs-CRP可能在识别CAVD早期患者以及药物治疗可能有助于阻止进展为不可逆主动脉瓣钙化和狭窄的患者方面发挥作用。

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