Soysal Dilek, Karakuş Volkan, Yavaş Hakan Haldun, Biçeroğlu Serdar, Köseoğlu Mehmet, Yeşil Murat
Department of Internal Medicine 1st Division, Atatürk Research and Training Hospital, İzmir, Turkey.
Anadolu Kardiyol Derg. 2010 Oct;10(5):421-8. doi: 10.5152/akd.2010.140.
We aimed to assess the relationship between C-reactive protein (CRP) and the severity and diffusion of coronary artery lesions in patients with unstable angina pectoris (UAP) and the independent association of CRP with this clinical situation.
This cross-sectional, observational study included 50 patients. Classification by Braunwald was used for UAP. The severity and diffusion of angiographic coronary disease were graded according to Reardon's modified scoring system. Plasma CRP levels were quantified by immunoturbidimetry. Nonparametric tests were used for comparison of CRP and other risk factors, and logistic regression analysis for evaluation of independent association between CRP and unstable angina pectoris.
The severity score was 46±18 points in class IIB1 UAP, 36±20 points in class IIB2 and 53±18 points in class IIIB2 (p=0.017, class IIIB2 vs IIB2). Respectively, CRP levels were 6.6 mg/L, 3.8 mg/L and 4.8 mg/L (p=0.371, class IIB1 vs IIB2 vs IIIB2). Lesions with diffusion score 4 revealed higher CRP values than lesions with diffusion score 1 (11.1 mg/L vs 3.1 mg/L, p=0.048). Adjusting age, sex and smoking, assessment of partial correlation analysis showed a positive, moderately powerful and significant association between CRP levels and the severity and diffusion scores of the coronary lesions (r=0.30; p=0.034 and r=0.31; p=0.030, respectively) in the whole study group. Multiple logistic regression analysis showed no appreciable independent association between CRP and UAP (OR: 1.63, 95%CI: 0.90-5.63, p=0.093).
Although, CRP was correlated with the severity and diffusion of angiographic coronary disease in patients with UAP, there was no independent association between CRP and clinical severity of UAP.
我们旨在评估不稳定型心绞痛（UAP）患者中C反应蛋白（CRP）与冠状动脉病变严重程度及病变范围之间的关系，以及CRP与这种临床情况的独立相关性。
这项横断面观察性研究纳入了50例患者。UAP采用Braunwald分类法。冠状动脉造影疾病的严重程度和病变范围根据Reardon改良评分系统进行分级。采用免疫比浊法对血浆CRP水平进行定量测定。采用非参数检验比较CRP与其他危险因素，并采用逻辑回归分析评估CRP与不稳定型心绞痛之间的独立相关性。
IIB1级UAP的严重程度评分为46±18分，IIB2级为36±20分，IIIB2级为53±18分（p = 0.017，IIIB2级与IIB2级相比）。CRP水平分别为6.6 mg/L、3.8 mg/L和4.8 mg/L（p = 0.371，IIB1级与IIB2级与IIIB2级相比）。病变范围评分为4的病变的CRP值高于病变范围评分为1的病变（11.1 mg/L对3.1 mg/L，p = 0.048）。在整个研究组中，调整年龄、性别和吸烟因素后，偏相关分析显示CRP水平与冠状动脉病变的严重程度和病变范围评分之间存在正相关、中等强度且显著相关（r = 0.30；p = 0.034和r = 0.31；p = 0.030）。多因素逻辑回归分析显示CRP与UAP之间无明显独立相关性（OR：1.63，95%CI：0.90 - 5.63，p = 0.093）。
虽然CRP与UAP患者冠状动脉造影疾病的严重程度和病变范围相关，但CRP与UAP的临床严重程度之间无独立相关性。
