【摘要】目的探讨急性冠脉综合征患者冠状动脉造影时伴有造影剂滞留现象与其血清高敏C反应蛋白的关系。方法根据冠状动脉造影结果，分成冠状动脉造影正常组、高度狭窄组和存在造影剂滞留组。冠状动脉造影采用标准术式，取右侧股动脉为穿刺入路，造影剂采用低渗非离子型。高敏C反应蛋白测定采用免疫增强的散射比浊法，在全自动特种蛋白分析仪上完成。统计学分析应用SPSS 11.0统计软件包。结果3组之间血清高敏C反应蛋白浓度水平差异有显著性(F=11.21，P<0.001)。冠状动脉造影时有造影剂滞留组急性冠脉综合征患者，其血清高敏C反应蛋白浓度水平明显高于冠状动脉造影正常人和有严重狭窄组的稳定型心绞痛患者的血清浓度水平(P<0.01，95%CI：-7.65～2.40；P<0.01，95%CI：-6.97～-0.86)。结论冠状动脉造影有造影剂滞留处的血管可能存在易损斑块，而该处病变血管可能是急性冠脉综合征患者的“罪犯”血管。

    关键词:冠状动脉造影造影剂;滞留高敏C反应蛋白易损斑块

    Elevated serum hypersensitive C-reactive protein concentration in acute coronary syndrome patients with contrast medium retard during coronary angiography

    Fan Changqing,Liu Pidong,Tian Ye,et al.

    Department of Cardiology,The 174th Hospital of PLA,Xiamen 361001.

    【Abstract】ObjectiveTo investigate the relation between serum hypersensitive C-reactive protein(hs-CRP)concentrations and specific coronary angiographic features of contrast medium retard in acute coronary syndrome(ACS)patients.MethodsNormal group,coronary artery serious stenosis group and contrast medium retard group were classified according to coronary angiography results.Coronary angiography was performed according to standard techniques through the right femoral artery.A low osmolarity ionic contrast medium was used during the procedure.Serum hs CRP concentration level was measured on an automated biochemistry analyzer(Beckman.Com.US).Immunoturbidimetric test was used.SPSS 11.0 statistics software package was used to analyze acquired data.ResultsThere were much significant differences in serum hs-CRP concentrations among the three groups(F=11.2,P<0.001).The level of serum hs CRP concentration in ACS patients with coronary angiographic features of contrast medium retard was much higher than coronary angiography showing normal group and coronary artery serious stenosis group,respectively(P<0.01,95%CI,-7.65～2.40;P<0.01,95%CI,-6.97～-0.86).ConclusionThere probably is vulnerable plaque in the vessel where exist to be a coronary angiographic features of contrast medium retard.The vessel with such features of coronary lesions in ACS patients may be the “culprit vessel” trying to find. ......