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C反应蛋白作为血管风险预测指标的临床意义

Clinical implications of C-reactive protein as a predictor of vascular risk.

作者信息

Katrinchak Carolyn, Fritz Kathryn

出版信息

J Am Acad Nurse Pract. 2007 Jul;19(7):335-40. doi: 10.1111/j.1745-7599.2007.00234.x.

Abstract

PURPOSE

To describe the role of C-reactive protein (CRP) as a marker of risk for coronary heart disease (CHD) and its role in risk reduction and disease prevention for the primary care provider.

DATA SOURCES

Extensive review of scientific literature on CRP and CHD.

CONCLUSIONS

Despite the scientific knowledge we have gained about prevention, risk factors, detection, and treatment, there are still high rates of CHD and acute coronary syndromes in the United States. With greater understanding of the role of inflammation in atherothrombotic disease, much attention has been given to monitoring CRP as a marker of risk for CHD. Guidelines for the use of CRP in clinical practice have been developed by the American Heart Association and Centers for Disease Control and Prevention; however, there is little specific guidance on how primary care providers should apply pharmaceutical strategies to reduce elevated levels of CRP.

IMPLICATIONS FOR PRACTICE

There is increasing evidence that CRP is an independent risk factor for CHD, can be a valuable tool in assessing at-risk populations, and provide additional information for the prevention of cardiovascular disease, which can assist the nurse practitioner target patients who may need lifestyle modifications that traditional screening tests may not identify.

摘要

目的

描述C反应蛋白(CRP)作为冠心病(CHD)风险标志物的作用及其在初级保健提供者降低风险和疾病预防中的作用。

数据来源

对有关CRP和CHD的科学文献进行广泛综述。

结论

尽管我们在预防、风险因素、检测和治疗方面已积累了科学知识,但美国的冠心病和急性冠脉综合征发病率仍然很高。随着对炎症在动脉粥样硬化血栓形成性疾病中作用的深入了解,CRP作为冠心病风险标志物的监测受到了广泛关注。美国心脏协会和疾病控制与预防中心已制定了临床实践中使用CRP的指南;然而,对于初级保健提供者应如何应用药物策略来降低升高的CRP水平,几乎没有具体指导。

对实践的启示

越来越多的证据表明,CRP是冠心病的独立危险因素,可作为评估高危人群的宝贵工具,并为预防心血管疾病提供额外信息,这有助于执业护士确定可能需要进行传统筛查测试无法识别的生活方式改变的患者。

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