De Haro Joaquin, Acin Francisco, Medina Francisco Jose, Lopez-Quintana Alfonso, March Jose Ramon
Department of Angiology and Vascular Surgery, Getafe University Hospital.
Clin Med Cardiol. 2008 Dec 23;3:1-7. doi: 10.4137/cmc.s1062.
To determine whether the increase in plasma levels of C-Reactive Protein (CRP), a non-specific reactant in the acute-phase of systemic inflammation, is associated with clinical severity of peripheral arterial disease (PAD).
This is a cross-sectional study at a referral hospital center of institutional practice in Madrid, Spain. A stratified random sampling was done over a population of 3370 patients with symptomatic PAD from the outpatient vascular laboratory database in 2007 in the order of their clinical severity: the first group of patients with mild chronological clinical severity who did not require surgical revascularization, the second group consisted of patients with moderate clinical severity who had only undergone only one surgical revascularization procedure and the third group consisted of patients who were severely affected and had undergone two or more surgical revascularization procedures of the lower extremities in different areas or needed late re-interventions. The Neyman affixation was used to calculate the sample size with a fixed relative error of 0.1. A homogeneity analysis between groups and a unifactorial analysis of comparison of medians for CRP was done. The groups were homogeneous for age, smoking status, Arterial Hypertension HTA, diabetes mellitus, dyslipemia, homocysteinemia and specific markers of inflammation. In the unifactorial analysis of multiple comparisons of medians according to Scheffé, it was observed that the median values of CRP plasma levels were increased in association with higher clinical severity of PAD (3.81 mg/L [2.14-5.48] vs. 8.33 [4.38-9.19] vs. 12.83 [9.5-14.16]; p < 0.05) as a unique factor of tested ones.
Plasma levels of CRP are associated with not only the presence of atherosclerosis but also with its chronological clinical severity.
确定全身性炎症急性期的非特异性反应物——血浆C反应蛋白（CRP）水平升高是否与外周动脉疾病（PAD）的临床严重程度相关。
这是一项在西班牙马德里一家机构性实践的转诊医院中心进行的横断面研究。2007年，从门诊血管实验室数据库中对3370例有症状的PAD患者进行分层随机抽样，按照临床严重程度排序：第一组为临床严重程度较轻且无需手术血运重建的患者；第二组为临床严重程度中等且仅接受过一次手术血运重建手术的患者；第三组为病情严重且在不同部位接受过两次或更多次下肢手术血运重建手术或需要后期再次干预的患者。采用奈曼固定法计算样本量，固定相对误差为0.1。对各组进行了同质性分析，并对CRP中位数进行了单因素比较分析。各组在年龄、吸烟状况、动脉高血压（HTA）、糖尿病、血脂异常、高同型半胱氨酸血症和炎症特异性标志物方面具有同质性。在根据谢费法进行的中位数多重比较单因素分析中，观察到CRP血浆水平的中位数随着PAD临床严重程度的增加而升高（3.81mg/L[2.14 - 5.48]对比8.33[4.38 - 9.19]对比12.83[9.5 - 14.16]；p<0.05），这是所测试的唯一因素。
CRP血浆水平不仅与动脉粥样硬化的存在有关，还与其临床严重程度有关。
