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| Clinical study on relationship of hs-CRP level with presence and prognosis of cardiac dysfunction in patients with type 2 diabetes after percutaneous coronary intervention |
| GAO Naishu,ZHENG Yanrong,ZHENG Fengzhi,DENG Wenjun,ZHU Xiaoxue, ZHANG Ying |
| Department of Clinical Laboratory,Peking University Shougang Hospital,Beijing 100144, China |
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Abstract Objective To investigate the relationship of high-sensitivity C-reactive protein (hs-CRP) level with cardiac dysfunction in patients with type 2 diabetes after percutaneous coronary interventions (PCI) for coronary heart disease (CHD) and its prognostic value.Methods 120 patients who suffered from cardiac dysfunction with type 2 diabetes after PCI for CHD were included in this study, and another 42 healthy people getting check-ups were selected as control group. Clinical baseline levels for blood lipids, hs-CRP, BNP and echocardiography were obtained.Follow-ups of main adverse cardiovascular and cerebrovascular events(MACCE) including death, myocardial infarction, stroke and repeated revascularization were done for 12 months. Data analysis using SPSS statistical software was conducted. Results Patients with cardiac dysfunction were divided into three groups by NYHA heart function classification, including Group C(class Ⅰ and Ⅱ), Group D(class Ⅲ), Group E (class Ⅳ), The levels of hs-CRP, BNP, left ventricular end diastolic volume (LVEDV) and left ventricular end systolic volume (LVESV) in all these three groups were obviously higher than those in the control group, and along with the increase of heart function classification, the levels increased; there was statistically significant difference (P<0.05). The left ventricular ejection fraction (LVEF) levels were obviously higher than that in the control group, and decreased with the increase of heart function classification; the difference was statistically significant (P<0.05). Linear regression analysis showed positive correlation between hs-CRP and BNP,(r=0.52, P<0.05)and negative correlation between hs-CRP and LVEF, (r=(0.67, P<0.05) ;hs-CRP was independent of LVEDV and LVESV; there was positive correlation between BNP and LVEDV,LVESV, (r=0.42, P<0.05; r=0.39, P<0.05, respectively) , and negative correlation with LVEF, (r=-0.78,P<0.05). BNP was superior to hs-CRP in the evaluation and diagnosis of heart failure.Further multivariate logistic regression analysis after grouping according to the occurrence of MACEE showed that both hs-CRP and BNP were independent risk factors of MACEE(P<0.05). Conclusion hs-CRP is independent predictor for cardiac dysfunction. It can effectively help assess the present risk and prognosis of cardiac dysfunction, and has great clinical value in detecting and evaluating cardiovascular diseases.
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Received: 11 January 2015
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| [1] |
陈 涛,张春晓,米 杰,等. 冠心病合并糖尿病患者PCI 术后支架内再狭窄相关因素分析. 山东医药,2014,54(30):50-51.
|
| [2] |
Wang Y, Wang X, Lau W B, et al. Adiponectin Inhibits Tumor Necrosis Factor-alpha-Induced Vascular Inflammatory Response via Caveolin-Mediated Ceramidase Recruitment and Activation[J]. Circ Res, 2014,114(5):792-805.
|
| [2] |
Wang Y, Wang X, Lau W B, et al. Adiponectin Inhibits Tumor Necrosis Factor-alpha-Induced Vascular Inflammatory Response via Caveolin-Mediated Ceramidase Recruitment and Activation[J]. Circ Res, 2014,114(5):792-805.
|
| [3] |
叶应妩,王毓三,申子瑜.全国临床检验操作规程[M].3版.南京:东南大学出版社,2006:9-100.
|
| [3] |
叶应妩,王毓三,申子瑜.全国临床检验操作规程[M].3版.南京:东南大学出版社,2006:9-100.
|
| [4] |
Abrams S T, Zhang N, Dart C, et al. Human CRP defends against the toxicity of circulating histones[J]. J Immunol 2013,191(5):2495-2502.
|
| [5] |
陈简庆,张民乐,吴伟军. 冠心病心力衰竭患者血尿酸、脑钠肽、高敏C反应蛋白与左室射血分数的相关性分析[J]. 实用医学杂志, 2012,28(2):239-240.
|
| [4] |
Abrams S T, Zhang N, Dart C, et al. Human CRP defends against the toxicity of circulating histones[J]. J Immunol 2013,191(5):2495-2502.
|
| [6] |
孙桂兰,罗春苗,徐达华,等. 高血压病合并糖尿病患者血浆hs-CRP、BNP与左室功能关系的研究[J]. 中国循证心血管医学杂志, 2010,8,9(16):159-161.
|
| [5] |
陈简庆,张民乐,吴伟军. 冠心病心力衰竭患者血尿酸、脑钠肽、高敏C反应蛋白与左室射血分数的相关性分析[J]. 实用医学杂志, 2012,28(2):239-240.
|
| [7] |
李曙光,杨 华,邹开力,等. 脑钠肽在老年呼吸困难鉴别诊断中的临床意义[J]. 中国临床实用医学,2014,5(6):60-61.
|
| [6] |
孙桂兰,罗春苗,徐达华,等. 高血压病合并糖尿病患者血浆hs-CRP、BNP与左室功能关系的研究[J]. 中国循证心血管医学杂志, 2010,8,9(16):159-161.
|
| [7] |
李曙光,杨 华,邹开力,等. 脑钠肽在老年呼吸困难鉴别诊断中的临床意义[J]. 中国临床实用医学,2014,5(6):60-61.
|
| [8] |
张 婉,鄢盛恺,娄晋宁. B型利钠肽_氨基末端B型利钠肽前体的实验室检测及在心力衰竭的临床应用[J]. 医学研究杂志,2013,4(42):15-17.
|
| [8] |
张 婉,鄢盛恺,娄晋宁. B型利钠肽_氨基末端B型利钠肽前体的实验室检测及在心力衰竭的临床应用[J]. 医学研究杂志,2013,4(42):15-17.
|
| [9] |
张晓波,陶 凌,张晓锋,等. 脑钠肽指导下与临床经验治疗心功能不全的疗效比较[J]. 中国医刊,2013,48(11):32-34.
|
| [9] |
张晓波,陶 凌,张晓锋,等. 脑钠肽指导下与临床经验治疗心功能不全的疗效比较[J]. 中国医刊,2013,48(11):32-34.
|
| [10] |
孙玉杰,张海澄. 新指南时代心电图在急性冠脉综合征中的价值[J]. 中国临床医生杂志,2015,43(5):379-381.
|
| [10] |
孙玉杰,张海澄. 新指南时代心电图在急性冠脉综合征中的价值[J]. 中国临床医生杂志,2015,43(5):379-381.
|
| [11] |
Li X, Chen C, Gan F. Plasma NT pro-BNP, hs-CRP and big-ET levels at admission as prognostic markers of survival in hospitalized patients with dilated cardiomyopathy: a single-center cohort study[J]. Bmc Cardiovasc Disord, 2014,14:67.
|
| [11] |
Li X, Chen C, Gan F. Plasma NT pro-BNP, hs-CRP and big-ET levels at admission as prognostic markers of survival in hospitalized patients with dilated cardiomyopathy: a single-center cohort study[J]. Bmc Cardiovasc Disord, 2014,14:67.
|
| [12] |
Babaei M, Dashti N, Lamei N, et al. Evaluation of plasma concentrations of homocysteine, IL-6, TNF-alpha, hs-CRP, and total antioxidant capacity in patients with end-stage renal failure[J]. Acta Med Iran, 2014,52(12):893-898.
|
| [12] |
Babaei M, Dashti N, Lamei N, et al. Evaluation of plasma concentrations of homocysteine, IL-6, TNF-alpha, hs-CRP, and total antioxidant capacity in patients with end-stage renal failure[J]. Acta Med Iran, 2014,52(12):893-898.
|
| [13] |
魏玉杰, 刘惠亮. 急性冠脉综合征炎性标志物hsCRP与sVCAM-1的表达及临床意义[J].武警医学,2007,18(12) : 913-915.
|
| [13] |
魏玉杰, 刘惠亮. 急性冠脉综合征炎性标志物hsCRP与sVCAM-1的表达及临床意义[J].武警医学,2007,18(12) : 913-915.
|
| [14] |
刘幼根,杨应军,朱建峰,等. 曲米他嗪对冠心病合并2型糖尿病心衰患者CRP及BNP的影响. 实用医学杂志,2011,27(6) :1119.
|
| [14] |
刘幼根,杨应军,朱建峰,等. 曲米他嗪对冠心病合并2型糖尿病心衰患者CRP及BNP的影响. 实用医学杂志,2011,27(6) :1119.
|
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2015, Vol. 26 
