Coronary heart disease, namely coronary atherosclerotic heart disease, is the most harmful heart disease in the world at present, and it is also the first cause of hospitalization and death of adult heart disease in China. The root cause of coronary heart disease is atherosclerosis. Recent studies show that atherosclerosis is not a simple lipid deposition disease, and inflammation plays an important role in the initiation and progress of atherosclerosis [1-4]. High-sensitivity C-reactive protein (hs-CRP) is a sensitive marker reflecting this inflammation and has been regarded as an independent risk factor of coronary heart disease.
1 objects and methods
1. 1 Subjects were selected from 1 et in October 2006 to 3 1 Et in February 2007. Patients with coronary heart disease in the Department of Cardiology, Shanxi Provincial People's Hospital 136, including 82 males and 54 females, aged 50-80 years. The control group included 150 outpatients, including 75 males and 75 females, aged 50-80 years. All subjects were excluded from trauma, tumor, rheumatism, acute and chronic infection and other diseases. There is no significant difference in age and gender between the groups.
1.2 research methods all subjects took 3 ml of fasting venous blood in the morning (including patients with coronary heart disease once at admission and once after treatment), centrifuged at 3 000rpm 10min, and separated serum to determine hs-CRP；; . The instrument is German Delin BNP- 100.
Special protein analyzer, the reagent is Delin original hs-CRP reagent, and it is determined by immune scattering turbidimetry.
1.3 statistical methods The measurement data were expressed by (x s), and the comparison between groups was made by t test.
Two results
2. 1 Compared with the control group, the serum hs-CRP in patients with SAP, UAP and AMI increased significantly (P
Table1comparison of serum hs-CRP between patients with SAP, UAP and AMI and control group.
project
Number of cases
Hs-CRP (mg/l)
energy
3 1
28. 1 23.7
Unknown aviation phenomenon
64
42.6 4 1.9
Advanced Material Information (advanced material information)
4 1
69.7 60.6
Health comparison table
150
1.2 0.5
2.2 The level of hs-CRP in patients with coronary heart disease at admission was higher than that at discharge, with significant difference (P
Comparison of hs-CRP levels in patients with coronary heart disease at admission and discharge.
project
Admission hs-CRP
Discharge hs-CRP
P
energy
42.6 4 1.9
1 1.8 8.6
& lt0.05
Unknown aviation phenomenon
28. 1 23.7
8.2 4.2
& lt0.05
Advanced Material Information (advanced material information)
69.7 60.6
16.2 5.8
& lt0.0 1
3 discussion
1930 Tillett et al. [5] found that the serum of patients with acute infection can react with pneumococcal component C, and later found that the serum reactant is a kind of protein, so it was named C-reactive protein, CRP). CRP is a spatial annular sphere composed of five identical monomers, with a molecular weight of 120 kD and a half-life of 19 h in human body. C-reactive protein (CRP) exists in the serum of healthy people in trace form under normal circumstances. When the body has acute inflammation, trauma, tumor, acute reaction and coronary heart disease, this protein will increase significantly. CRP is an acute inflammatory phase reaction protein, which is mainly synthesized and secreted by the liver under stress. CRP level is a sensitive index to judge tissue injury. Serum CRP level can increase rapidly within 6 ~ 8 hours after injury, and reach the peak in 48 ~ 72 hours. CRP can also be produced in human coronary arteries, especially in the intima of atherosclerotic blood vessels. Compared with CRP, hs-CRP is only more accurate and sensitive, so it is called highly sensitive C-reactive protein (hs-CRP). Hs-CRP in human body remains unchanged for a long time. No time change, not affected by diet, easy to monitor in the blood.
CRP mainly causes lipid deposition by activating the complement system, thus damaging blood vessels and reducing and inactivating the function of nitric oxide (NO). NO rapidly decomposes and releases a large number of free radicals, causing vasospasm, abnormal lipid metabolism, atherosclerosis and myocardial ischemia and hypoxia, thus causing myocardial ischemic events [6-7]. The relationship between coronary heart disease and inflammation has been paid more and more attention. Some studies have found that C- reactive protein deposition can be seen in early atherosclerotic plaques. In addition, there were foam cells with positive staining of C- reactive protein in the lesion. At the same time, a lot of complement terminal reaction protein C5a-9 was deposited. Inflammatory reaction of coronary plaque plays an important role in acute coronary thrombosis and plaque rupture. Inflammation can stimulate cytokines and growth factors, produce and activate the complement system, and through the interaction with endothelial cells and smooth muscle cells, injured endothelial cells induce the proliferation of smooth muscle cells, thus participating in the occurrence and development of acute coronary syndrome [8].
From the results of this study, it can be seen that the increase of C-reactive protein in patients with coronary heart disease varies according to the development of the disease. Acute myocardial infarction is higher than patients with unstable angina pectoris, and serum C-reactive protein in patients with unstable angina pectoris is higher than that in patients with stable angina pectoris. For patients with stable angina pectoris, unstable angina pectoris and acute myocardial infarction, the level of serum C-reactive protein at admission after treatment is higher than that at discharge, suggesting that C-reactive protein is closely related to the occurrence and development of coronary heart disease.
To sum up, C-reactive protein may be a risk factor for coronary heart disease. Serum C-reactive protein level can predict the occurrence and development of coronary heart disease, and CRP can be used as the main laboratory index for grading the risk degree of coronary heart disease and judging the prognosis.