心血管病患者血清hsCRP水平及血管内皮功能的研究
|
摘要
【研究目的】探讨和评价血清hsCRP水平在筛选心血管病高危患者中的作用；了解高血压患者血管内皮依赖性舒张功能的变化及相关影响因素。
【研究方法】2004年10月至2006年3月，因心血管疾病入住我院心内科的患者共216例，其中男152例，女64例，平均年龄48.6±18.4(31～83)岁。按临床表现分为：①高危心血管病组(high risk patient group，HRP)：共68例(男49例、女19例)，平均年龄50.2±18.7岁，包括急性冠状动脉综合征(ACS)和急性主动脉夹层动脉瘤(ADA)患者；②低危心血管病组(low risk patient group，LRP)：共82例(男59例、女23例)，平均年龄49.1±18.1岁，包括单纯轻中度高血压、稳定性心绞痛患者：③对照组(Control group)：共66例(男44例，女22例)，平均年龄46.6±15.7岁，为同期因阵发性室上性心动过速(PSVT)或心悸／胸闷(出院诊断为“心脏神经官能症”者)入院，且已排除其他心血管疾病的患者；比较三组患者血清hsCRP水平。另于2005年3月至2006年3月入选62例因原发性高血压入院的中青年患者，其中男55例，女7例，平均年龄44.97±8.20(29～65)岁。根据患者血压水平、肥胖情况、阻塞性睡眠呼吸暂停综合征(OSAS)的严重程度等检测指标进行分组，以肱动脉超声研究血管内皮依赖性舒张功能(EDD)的变化及相关影响因素。
【研究结果】①HRP组与LRP组患者血清hsCRP水平均显著高于对照组；以急性冠状动脉综合征(ACS)为主的HRP组，其血清hsCRP水平非常显著的高于LRP组(p＜0.01)；以血清hsCRP＞3.0mg／L为判定高危心血管病患者的标准时，其敏感性和特异性均在75％左右；对照组和LRP组的血清CK-MB或cTnI水平均在正常范围内，ACS患者血清hsCRP水平与CK-MB或cTnI水平无明显相关性。②重度高血压患者的血管内皮依赖性舒张功能有显著下降(p＜0.01)，其他影响血管内皮依赖性舒张功能的主要因素还有中心性肥胖(p＜0.01)和睡眠呼吸暂停综合征(p＜0.05)。
【研究结论】①HRP组血清hsCRP水平非常显著的高于LRP组(p＜0.01)，以血清hsCRP＞3.0mg／L为高危心血管病患者的判定标准时，具有较好的敏感性和特异性，但临床诊断须结合其它相关资料。②高血压患者血管内皮依赖性舒张功能的下降可能是血管损伤的早期表现，中心性肥胖及睡眠呼吸暂停综合征也可能是重要的影响因素。
Objective To evaluate the level of serum high-sensitivity C-reactive protein (hsCRP)as an important indicator for early risk stratification in patients with an acute coronarysyndrome (ACS) or other high risk vascular disease. To observe the changes ofendothelium dependent diastolic function in patients with hypertension and otherinfluencing factors (such as obesity and obstructive sleep apnea syndrome).
Methods In 216 consecutive patients, the level of serum hsCRP were analyzed.Include 152 male and 64 female, mean age 48.64±18.4 (31-83)yr. According to the clinicalmanifestation, the patients were divided into three groups:①High risk patient group(HRP), 68 patients (49 male and 19 female), mean age 50.2±18.7 yr, include acute coronarysyndrome (ACS) and aortic dissecting aneurysm (ADA);②Low risk patient group (LRP),82 patients (59 male and 23 female), mean age 49.1±18.1 yr, include essential hypertension(BP＜180/110mmHg) and stable angia pectoris;③Control group, 66 patients (44 male and22 female) without vascular disease, mean age 46.6±15.7yr. The 62 consecutive young andmiddle-aged patients with essential hypertension in which some from LRP group, 55 maleand 7 female, mean age 44.97±8.20 (29-65) yr. The group were divided by the bloodpressure level, degree of obesity or obstructive sleep apnea syndrome (OSAS). The highresolution ultrasound was applied to measure brachial artery flow-mediated endothelium-dependent dilation and glyceryhrinitrate (GNT) -mediated endothelium-independent dilation.
Results①Compared with the control group (0.37±0.25mg/L), the serum hsCRPlevels in both of LRP group (1.28±0.79 mg/L, p＜0.05) and HRP group (5.82±3.94 mg/L,p＜0.01) were significantly increased; the level of serum hsCRP in HRP group was alsosignificantly higher than that in LRP group (p＜0.01). The cutoff values were 3.0mg/L forserum hsCRP, its sensitivity and specificity for patients with high risk cardiovasculardisease (especially ACS or ADA) were 73.53% and 75.36% respectively; the false positiverate is 11.49%, and the false negative rate is 26.47%. The levels of serum CK-MB (cutoff value 25IU/L) and cTnl (cutoff value 0.1μg/L) in control and LRP groups are normal. Theserum levels of CK-MB and cTnI are not related to the hsCRP level.②The endotheliumdependent diastolic function (EDD) in severe hypertension group (BP≥180/110mmHg) wasdecreased significantly versus the mild hypertension group (p＜0.01). Central-type obesityand OSAS could also affect EDD obviously.
Conclusion①The level of serum hsCRP in HRP group was obviously higher thanother groups. The 3.0 mg/L serum hsCRP as cutoff value is useful for identifying thepatients with ACS or ADA. But the final diagnosis should be made by combination withother important clinical data.②The decrease of endothelium dependent diastolic function(EDD) in hypertension may be an early appearance of the damage in arterial wall.Central-type obesity and OSAS may also influence EDD as important factors.
【研究方法】2004年10月至2006年3月，因心血管疾病入住我院心内科的患者共216例，其中男152例，女64例，平均年龄48.6±18.4(31～83)岁。按临床表现分为：①高危心血管病组(high risk patient group，HRP)：共68例(男49例、女19例)，平均年龄50.2±18.7岁，包括急性冠状动脉综合征(ACS)和急性主动脉夹层动脉瘤(ADA)患者；②低危心血管病组(low risk patient group，LRP)：共82例(男59例、女23例)，平均年龄49.1±18.1岁，包括单纯轻中度高血压、稳定性心绞痛患者：③对照组(Control group)：共66例(男44例，女22例)，平均年龄46.6±15.7岁，为同期因阵发性室上性心动过速(PSVT)或心悸／胸闷(出院诊断为“心脏神经官能症”者)入院，且已排除其他心血管疾病的患者；比较三组患者血清hsCRP水平。另于2005年3月至2006年3月入选62例因原发性高血压入院的中青年患者，其中男55例，女7例，平均年龄44.97±8.20(29～65)岁。根据患者血压水平、肥胖情况、阻塞性睡眠呼吸暂停综合征(OSAS)的严重程度等检测指标进行分组，以肱动脉超声研究血管内皮依赖性舒张功能(EDD)的变化及相关影响因素。
【研究结果】①HRP组与LRP组患者血清hsCRP水平均显著高于对照组；以急性冠状动脉综合征(ACS)为主的HRP组，其血清hsCRP水平非常显著的高于LRP组(p＜0.01)；以血清hsCRP＞3.0mg／L为判定高危心血管病患者的标准时，其敏感性和特异性均在75％左右；对照组和LRP组的血清CK-MB或cTnI水平均在正常范围内，ACS患者血清hsCRP水平与CK-MB或cTnI水平无明显相关性。②重度高血压患者的血管内皮依赖性舒张功能有显著下降(p＜0.01)，其他影响血管内皮依赖性舒张功能的主要因素还有中心性肥胖(p＜0.01)和睡眠呼吸暂停综合征(p＜0.05)。
【研究结论】①HRP组血清hsCRP水平非常显著的高于LRP组(p＜0.01)，以血清hsCRP＞3.0mg／L为高危心血管病患者的判定标准时，具有较好的敏感性和特异性，但临床诊断须结合其它相关资料。②高血压患者血管内皮依赖性舒张功能的下降可能是血管损伤的早期表现，中心性肥胖及睡眠呼吸暂停综合征也可能是重要的影响因素。
Objective To evaluate the level of serum high-sensitivity C-reactive protein (hsCRP)as an important indicator for early risk stratification in patients with an acute coronarysyndrome (ACS) or other high risk vascular disease. To observe the changes ofendothelium dependent diastolic function in patients with hypertension and otherinfluencing factors (such as obesity and obstructive sleep apnea syndrome).
Methods In 216 consecutive patients, the level of serum hsCRP were analyzed.Include 152 male and 64 female, mean age 48.64±18.4 (31-83)yr. According to the clinicalmanifestation, the patients were divided into three groups:①High risk patient group(HRP), 68 patients (49 male and 19 female), mean age 50.2±18.7 yr, include acute coronarysyndrome (ACS) and aortic dissecting aneurysm (ADA);②Low risk patient group (LRP),82 patients (59 male and 23 female), mean age 49.1±18.1 yr, include essential hypertension(BP＜180/110mmHg) and stable angia pectoris;③Control group, 66 patients (44 male and22 female) without vascular disease, mean age 46.6±15.7yr. The 62 consecutive young andmiddle-aged patients with essential hypertension in which some from LRP group, 55 maleand 7 female, mean age 44.97±8.20 (29-65) yr. The group were divided by the bloodpressure level, degree of obesity or obstructive sleep apnea syndrome (OSAS). The highresolution ultrasound was applied to measure brachial artery flow-mediated endothelium-dependent dilation and glyceryhrinitrate (GNT) -mediated endothelium-independent dilation.
Results①Compared with the control group (0.37±0.25mg/L), the serum hsCRPlevels in both of LRP group (1.28±0.79 mg/L, p＜0.05) and HRP group (5.82±3.94 mg/L,p＜0.01) were significantly increased; the level of serum hsCRP in HRP group was alsosignificantly higher than that in LRP group (p＜0.01). The cutoff values were 3.0mg/L forserum hsCRP, its sensitivity and specificity for patients with high risk cardiovasculardisease (especially ACS or ADA) were 73.53% and 75.36% respectively; the false positiverate is 11.49%, and the false negative rate is 26.47%. The levels of serum CK-MB (cutoff value 25IU/L) and cTnl (cutoff value 0.1μg/L) in control and LRP groups are normal. Theserum levels of CK-MB and cTnI are not related to the hsCRP level.②The endotheliumdependent diastolic function (EDD) in severe hypertension group (BP≥180/110mmHg) wasdecreased significantly versus the mild hypertension group (p＜0.01). Central-type obesityand OSAS could also affect EDD obviously.
Conclusion①The level of serum hsCRP in HRP group was obviously higher thanother groups. The 3.0 mg/L serum hsCRP as cutoff value is useful for identifying thepatients with ACS or ADA. But the final diagnosis should be made by combination withother important clinical data.②The decrease of endothelium dependent diastolic function(EDD) in hypertension may be an early appearance of the damage in arterial wall.Central-type obesity and OSAS may also influence EDD as important factors.
引文
1．吴兆苏，姚崇华，赵冬，等．11省市队列人群心血管病发病前瞻性研究Ⅱ．个体危险因素聚集与心血管病发病的关系[J]．中华心血管病杂志，2001，29(4)：246-250．
2．王薇，赵冬，刘静，等．中国35～64岁人群心血管病危险因素与发病危险的前瞻性研究．中华心血管病杂志，2003，31：902-908．
3. Rioufol G, Finer G, AndreoFouet X, et al. Multiple ruptures of at herosclerotic plaques in acute coronary syndrome. Endocoronaryult rasonography study of three arteries. Arch Mal Coeur Vaiss, 2002, 95: 157-165.
4. Naghavi M, Libby P, Falk E, et al. From vulnerable plaque to vulnerable patient: a call for new definitions and risk assessment strategies: Part Ⅰ. Circulation, 2003, 108: 1664-1672.
5. Naghavi M, Libby P, Falk E, et al. From vulnerable plaque to vulnerable patient: a call for new definitions and risk assessment st rategies: Part Ⅱ. Circulation, 2003, 108: 1772-1778.
6. Koukkunen H, Penttilak, Kemppainen A, et al. C-reactive protein fibrinogen interleukin-6 and tumor necrosis factor-alpha in the nrognosic classification of unstable angina pectors[J]Am Med, 2001, 33: 37.
7. Jose L Tortes, Paul M Ridker. clinical use of high sensitivity C- reactive protein for the prediction of adverse cardiovascular events[J].Current Opinion in Cardiology, 2003, 18: 471.
8. Lagrand WK, Visser CA, Hermens WT, et al. Coreactive protein as a cardiovascular risk factor: more than an epiphenomenona[J] ? Circulation, 1999, 100(1): 96-102.
9. Penn MS, Topoi EJ. Tissue factor, the emerging link between inflammation, thrombosis, and vascular remodeling.Cir Res, 2001, 89(1): 122.
10. Pasceri V, Willerson JT, Yeh ET. Direct proin flammatory effect of C-reactive protein on human endothelial cells.Circulation, 2000, 102(18): 2165-2168.
11. Yasojima K, Schwab C, McGeer EG. Generation of C-reactive protoin. and complement components in atherosclerotic plaques. Am J Pathol, 2001, 158(3): 1039-1051.
12. Ridker PM, Hennckens CH, Sclhub J, et al. C-reactive protein and its relation to cardiovascular risk factors: a population-based cross-sectional study[J]. BMJ, 1996, 312: 1061-1065.
13. Ridker PM, Cushman M, Stampfer M J, et al. Inflammation, aspirin and the risk of cardiovascular disease in apparently healthy men[J].N Eng J Med, 1997, 336: 973-979.
14. Roberts WL, Moulton L, Law TC, et al. Evaluation of nine automated high-sensitivity C-reactive protein methods: implications for clinical and epidemiological applications. Part 2.Clin Chem, 2001, 47: 418-425.
15. Ridker PM. High-sensitivity C-reactive protein: potential adjunct for global risk assessment in the primary prevention of cardiovascular disease. Circulation, 2001, 103: 1813-1818.
16. Mendall MA, Strachan DP, Butland BK, et al. C-reative protein: relation to total mortality, cardiovascular mortality and cardiovascular risk factors in men[J]. Eur Heart J, 2000, 21: 1584-1590.
17. Morrow DA, Ridker PM. C-reactive protein, inflammation and coronary risk[J]. Med Clin North Am, 2000, 84: 149-161.
18．黄先勇，李玉芳，沈洪，等．C-反应蛋白水平与急性心肌梗死溶栓患者预后的临床研究[J]．中华老年心脑血管病杂志，2001，3：387-389．
19. Wu JT, Wu LL. Linking inflammation and atherogenesis: Soluble markers identified for the detection of risk factors and for early risk assessment.Clinica chimica Acta, 2006, 366: 74-80.
20. Madamanchi NR, Vendrov A, Runge MS. Oxidative stress and vascular disease. Arterioscler Thromb Vasc Biol, 2005, 25: 29-38.
21. Bobryshev YV. Monocyte recruitment and foam cell formation in atherosclerosis. Micron, 2006, 37: 208-222.
22. Rodriguez-Granillo GA, Aoki J, Ong AT, et al. Methodological considerations and approach to cross-technique comparisons using in vivo coronary plaque characterization based on intravascular ultrasound radiofrequency data analysis: insights from the Integrated Biomarker and Imaging Study (IBIS). Int J Cardiovasc Intervent, 2005, 7(1): 52-8.
23. Koukkunen H, Penttila K, Kemppainen A, et al. C-reactive protein, fibrinogen, interleukin-6 and tumour necrosis factor-alpha in the prognostic classification of unstable angina pectoris. Ann Med, 2001, 33(1): 37-47.
24．周朝霞，马爱群，强华，等．血清可溶性CD40配体对急性冠状动脉综合征的诊断．西安交通大学学报，2006，27(1)：2-4．
25．胡厚源，宋治远，张永克，等．16层螺旋CT冠状动脉显像在冠心病诊断中的应用．重庆医学，2006，35(3)：212-213．
26．中华医学会心血管病学分会，中华心血管病杂志编辑委员会．急性心肌梗死诊断和治疗指南．中华心血管病杂志，2001，29：710-725．
27．中华医学会心血管病学分会，中华心血管病杂志编辑委员会．不稳定性心绞痛诊断和治疗建议．中华心血管病杂志，2000，28：409-412．
28．中国高血压防治指南修订委员会．2004年中国高血压防治指南(实用本)．中华心血管病杂志，2004，32：1060-1064．
29. Thompson D, Pepys MB, Wood SEThe physiological structure of human C-reactive protein and its complex with phosphocholine.Structure Fold Des, 1999, 7:169-177.
30. Clyne B, Olshaker JS. The C-reactive protein. J Emerg Med, 1999, 17(6): 1019-1031.
31. Pearson TA, Mensah GA, Alexander RW, et al. Markers of inflammation and cardiovascular disease: application to clinical and public health practice: a statement for healthcare professionals from the Centers for Disease Control and Prevention and the American Heart Association.Circulation, 2003, 107:499-511.
32. Elkind MSV. Inflammation, Atherosclerosis, and Stroke(review). The Neurologist, 2006, 12(3):140-148.
33. Ford ES, Giles WH. Serum C-reactive protein and self-reported stroke: findings from the Third National Health and Nutrition Examination Survey. Arterioscler Thromb Vasc Biol, 2000, 20: 1052-1056.
34. Tortes JL, Ridker PM. Clinical use of high sensitivity C- reactive protein for the prediction of adverse cardiovascular events. Curr Opin Cardiol, 2003, 18(6): 471-478.
35. de Winter RJ, Fischer J, Bholasingh R, et al. C-reactive protein and cardiac troponin T in risk stratification: differences in optimal timing of tests early after the onset of chest pain. Clinical Chemistry, 2000, 46(10): 1597-1603.
36. Piechota W, Piechota W. Correlation of high-sensitivity CRP concentration with the extent of coronary atherosclerosis in men with symptoms of ischemic heart disease[Article in Polish]. Pol Merkuriusz Lek. 2005, 18(107): 511-515.
37. Bolad I, Delafontaine P. Endothelial dysfunction: its role in hypertensive coronary disease. Curr Opin Cardiol, 2005, 20; 270-274.
38. Liu YJ, Li XH. Clinical progress of color Doppler ultrasound evaluating invasion of vascular endothelial function. Chin J Med Imaging Technol, 2003, 19(2): 240-241.
39．中华医学会耳鼻咽喉科学分会，中华耳鼻咽喉科杂志编委会．阻塞性睡眠呼吸暂停低通气综合征诊断依据和疗效评定标准暨悬雍垂腭咽成形术适应证(杭州)．中华耳鼻咽喉科杂志，2002，37(6)：403-404．
40. Celermajer DS, Sorensen K, Ryalls M, et al.Non-invasive detection of endothelial dysfunction in children and adults at risk of atherosclerosis. Lancet, 1992, 340: 1111-1115.
41. Hirsch AT. Vascular disease, hypertension, and prevention: "from endothelium to clinical events"[J].JACC, 2003, 42(2): 377-379.
42. Pagnin E, Giacon V, Zaghetto F, et al. Arterial hypertension and oxidative stress induced by cyclosporin effect of carvedilol[J].Ann ItalMed Int, 2001, 16(2): 101-105.
43．刘磊，郑振声，钱学贤，等．高血压患者与正常血压者皮肤微血管对乙酰胆碱和硝普钠反应性比较[J]．高血压杂志，2002，9(3)：187-190．
44. Higashi Y, Oshima T, Sasaki S, et al. Angiotensin-converting enzyme inhibition, but not calcium antagonism, improves a response of the renal vasculature to L-arginine in patients with essential hypertension[J]. Hypertension, 1998, 32:16-24.
45．李轶男，央瑞英，袁洪，等．老年高血压病患者VWF、GMP-140、LRP含量的研究[J]．心血管康复医学杂志，2001，10(1)：24-26．
46．桂鸣，黄峻，王海燕，等．非侵入法对高血压早期血管内皮功能障碍的评价．中国动脉硬化杂志，2003，11：242-244．
47．李卫萍，孙明，周宏研．高血压患者血管内皮依赖性舒张功能与血清一氧化氮和超氧化歧化酶的关系．中国动脉硬化杂志，2003，11：155-158．
48．中华医学会糖书尿病分会代谢综合征协作组．中华医学会糖尿病分会关于代谢综合征的建议[J]．中华糖尿病杂志，2004，12(3)：156-161．
49. Grundy SM, Brewer B, Cleeman Jl, et al.Definition of metabolic syndromelreport of the National Heart, Lung, and Blood Institute/ American Heart Association conference on scientific issues related to definition.Circulation, 2004, 109: 433.
50. Eckel R, Grundy SM, Zimmet PZ.Metabolic syndrome.Lancet, 2005, 365: 1415.
51. Dandona P, Aljada A, Chaudhuri A, et al.Metabolic syndrome: a comprehensive perspective based on interactions between obesity, diabetes, and inflammation. Circulation, 2005, 11: 1448.
52. Evans RM, Barish GD, Wang YX.PPARs and complex journey to obesity. Nat Med, 2004, 10: 1.
53．周北凡，阳丰，赵连成，等．我国中年人向心性肥胖和心血管危险因素及其聚集性[J]．中华心血管病杂志，2001，29(2)：70-73．
54. Forouhi NG, Sattar N, M cKeigue PM.Relation of C-reactive protein to body fat distribution and features of themetabolic Syndrom in Europeans and South A sians[J].Int J Obes Relat Metab Disord, 2001, 25(9): 1327-1331.
55．邹大进，李慧．肥胖，炎症与胰岛素抵抗[J]．国外医学内分泌学分册，2004，24(4)：附录223．
56. Hashimoto M, Akishita M, Eto M et al.The impairment of flow-mediated vasodilatation in obese men with visceral fat accumulation.Int J Obes Relat Metab Disord, 1998, 22(5): 477.
57. Das UN.Is obesity an inflammatory condition Nutrition? 2001, 17: 953-966.
58．汪冀，牛峰海，寻文龙，等．单纯性肥胖儿童内分泌功能和内皮依赖性舒张功能的研究[J]．中华儿科杂志，2000，38(7)：414-416．
59．孙明晓，迟家敏．肥胖与2型糖尿病．中国医刊，2005，40(1)：13-16．
60．戚丽，路中，董砚虎．糖尿病心血管病变的研究进展．国外医学内分泌学分册，2004，24(1)：71-72．
61．祝之明．代谢综合征的诊断和治疗．中华心血管病杂志，2004，32(12)：1163-1166．
62．邢小燕，杨文英．减重后体重反弹的防治策略．国外医学内分泌学分册，2005，25(1)：729．
63．邹大进．超重和肥胖——代谢综合征的主要病因．国外医学内分泌学分册，2005，25(3)：145-147．
64. Tamar S, Giora P.Sleep apnea in the older adult.Drugs Aging, 2003, 20:551-560.
65. Bixler EO, Vgontzas AN, Ten Have T, et al. Effects of age on sleep apnea in men: I. Prevalenca and severity. Am J Respir Crit Care Med, 1998, 157(1): 144-184.
66. Leeuw PW. On Sleep and death: Cardiovascular risk of the obstructive sleep apnea syndrome[J].Neth J Med, 1999, 54:188-190.
67. Parra O, Josep M, Adria Arboix, et al. Time course of sleep related breathing disorders in first-ever stroke or transient ischemic attack[J].Am J Respir Crit Care Med, 2000, 161: 375-380.
68. Wessendorf TE, Teschler H, YM Wang, et al. Sleep-disordered breathing among patients with first-ever stroke[J].J Neurol, 2000, 247: 41-47.
69. Nobili L, Schiavi G, Bozane E, et al. Morning increase of whole blood viscosity in obstructive sleep apnea syndrome[J]. Clin Hemorheol Microcirc, 2000, 22: 21-27.
70. Richard A, Ansarin K, Baran AS. Sleep apnea and hypertension: pathophysiologic mechanisms. Semin Nephrol.2002, 22: 71-77.
71. Shamsuzzaman AS, Winnicki M, Lanfranchi P, et al.Elevated C-reactive protein in patients with obstructive sleep apnea.Circulation, 2002, 105: 2462-2464.
72. Yokoe T, Minoguchi K, Mat suo H. Elevated levels of C-Reactive protein and interlrukin-6 in patients with obstructive sleep apnea syndrome are decreased by nasal continuous positive airway pressure. Circulation, 2003, 107(8): 1129-1134.
73. Good friend TL, Calhoun DA. Resistant hypertenion, obesity Sleep apnea and aldosterone: thory and therapy.Hypertension, 2004, 43:518-524.
74. Shamsuzzaman AS, Gersh BJ, Somers VK. Obstructive sleep apnea: implications for cardiac and vascular disease. JAMA, 2003, 290:1906-1914.
75．王毓洲．阻塞性睡眠呼吸暂停／低通气综合征的发病机理[J]．中国全科医学，2002，5(3)：178-179．
76．张希龙，童茂容，夏锡荣，等．鼾症老年人睡眠呼吸暂停症与心血管疾病的相关性[J]．中华老年心脑血管病杂志，2001，3(3)：150-152．
77. Kraiczi H, Caidahl K, Samuelsson A, et al. Impairment of vascular endothelial function and left ventricular filling: association with the severity of apnea-induced hypoxemia during sleep[J]. Chest, 2001, 119: 1085-1091.
78. Leung RST, Bradley TD. Sleep apnea and cardiovascular disease [J]. Am J Respir Crit Care Med, 2001, 164: 2147-2165.
79. Schafer H, Kohler U, Ploch T, et al.Coronary heart disease and upper airway obstruction[J].J Sleep Res, 1995,4(S1): 185-189.
80. Koehler V, Schafer H.Is obstructive sleep apnea a risk factor for myocardial infarction and cardiac arrhythmias in patients with coronary heart disease.Sleep, 1996, 19: 283-286.
81. Ip MS, Lam B, Ng MM, et al.Obstructive sleep apnea is independently associated with insulin resistance[J].AM J Respir Crit Care med 2002,165(5), 670-676.
1. Tillett WS, Fraecis T.Serological reactions in pneumonia with a nonprotein somatic of the pneumococcus[J]. JEXP Med 1930, 52(4): 561-571.
2. Thompson D, Pepys MB, Wood SEThe physiological Structure of human C-reactive protein and its complex with phosphocholine[J]. Structure Fold Des, 1999, 7(2): 169-177.
3. Clyne B, Olshaker JS.The C-reactive protein[J]. J Emerg Med, 1999, 17(6): 1019.
4．李建军．C-反应蛋白与冠心病的关系[J]．中国循环杂志，1994，14(5)：319．
5. Roberts WL, Mouton L, Law TC, et al.Evluation of nine anomataed high sensitivity C-reactive protein methods: implications for clinical and epidemio logical applications[J]. Clin Chem, 2001, 47:418-423.
6. Ross R. The pat hogenesis of at herosclerosis: a perspective for the 1990s[J]. Nature, 1993, 362: 801-2809.
7. Cooke JP. The endothelium: a new target for therapy[J]. VascMed, 2000, 5: 49—43.
8. Maseri A. Inflammation atheroseclerosis and ischemic events- exploring the hidden side of the moon[J]. N Engl J Med, 1997, 336: 1014.
9. Jose L Torres, Paul M Ridker. clinical use of high sensitivity C- reactive protein for the prediction of adverse cardiovascular events[J].Current Opinion in Cardiology, 2003, 18: 471.
10．胡大一，王宏宇，倪永斌．大动脉功能与心血管疾病[M]．北京：人民军医出版社，2003：94．
11. Ridker Paul M, Nader, Rifai, et al.Comparison of C-reactive protein and low-density lipoprotein cholesterol levels in the prediction of first cardiovascular events[J]. N Engl J Med, 2002, 347: 1557—1565
12. Paul M Ridker, Julie E Buring, Nancy R, et al.C-reactive protein, the Metabolic Syndrome, and risk of incident cardiovascular events: A 8-year follow-up of 14719 initially healthy American women[J]. Circulation, 2003, 107:391—397
13. Levine GN, Keaney J F, Vita JA. Cholesterol reduction in cardio- vascular disease.Clinical benefits and possible mechanisms[J]. N Engl J Med, 1995, 332(8): 512-521.
14. Celermajer DS, Sorensen KE, Gooch VM, et al. Noninvasive detection of enedothelial dysfunction in children and adults at task of atherosclerosis[J].Lancet, 1992, 340: 1111-1115.
15. Deng YB, Li TL, Xiang HJ, et al. Impaired endothelial function in the brachial artery after Kawasaki disease and the effects of intravenous administration of vitamin C[J]. Pediatr Infect Dis J, 2003, 22(1): 34-39.
16. Koenig W, Sund M, Froblich M, et al. C-reactive protein, a sensitive marker of inflammation, predicts future risk of coronary heart disease in initially healthy middle-aged men: results from the MONICA(Monitoring Trends and Determinants in Cardiovascular Disease) Augsburg Cohort Study, 1984 to 1992[J].Circulation, 1999, 99(2): 237—242.
17. Ridker Paul M. Clinical Application of C-reactive Protein for Cardiovascular disease Detection and Prevention[J]. Circulation, 2003, 107:363—369.
18. Pearson TA, Mensah G, Alexander RW, et al. Markers of inflammation and cardiovascular disease: Application to clinical and public health practice: A statement for healthcare professionals from the centers for Disease Control and Prevention and the American Heart Association[J]. Circulation, 2003, 107: 499—511.
19. Haver kate F, Hompson SG, Pyke SD, et al.Production of Coronary events in stable and unstable angina[J].Lancet, 1997, 349(9050): 462-466.
20．李崇剑，徐耕，傅国胜，等．血清C-反应蛋白与冠心病危险因素及冠状动脉病变的关系分析．中国循环杂志，2003，18：443．
21．朱士洲，急性心肌梗死患者C-反应蛋白含量与梗死面积和部位的关系[J]．临床心血管杂志，2003，19(11)：685-686．
22. Marrow DA, Rifai N, Antman EM, et al. C-reactive protein is a potent predictor of mortality independently of and in combination with troponin T in acute coronary syndromes: a TIMI Ⅱ A substudy[J]. J am Coll Cardiol, 1998, 31: 1460-1465.
23. Ueda S, Ikeda U, Yamamotok, et al. C-reactive protein as a predictor of cardiac rupture after acute myocardial infarction[J]. Am Heart J, 1996, 131: 1460-1465.
24. Anzai T, Yashikawa T, Kaneko H, et al. Association between serum C-reactive protein elevation and left ventriculor thrombus formation after frist anterior myocardial infarction[J]. Chest, 2004, 125(2): 384-389.
25．李崇剑，徐耕．急性冠脉综合征的生化标志物研究进展[J]．心血管病学进展，2002，22(6)：345-347．
26．蒋利，沈卫峰，张建成，等．C-反应蛋白对冠状动脉内支架术预后的预测价值[J]．中华心血管病杂志，2003，31(1)：45．
27．冯文文，钱菊英，周明成，等．血清C-反应蛋白对冠状动脉支架置入术后心血管事件和再狭窄的预测价值[J]．中华心血管病杂志，2003，31(7)：514-516．
28．于力，刘怀霖，赵亚军，等．急性心肌梗死发病6h内C-反应蛋白的检测及临床意义[J]．临床内科杂志，2002，19(1)：16-17．
29. Leonelo E Bautista, Patricio Lopez-Jaranillo, Lina M Vera, et al. Is C-reactive protein an independent risk factor for essential hypertension? [J]. Hypertension, 2001, 19:587—861.
30. Blake Gavin J, Rifai Nader, Buring Julie E, et al. Blood Pressure, C-Reactive Protein, and Risk of Future Cardiovascular Events[J].Circulation, 2003, 108(24): 2993—2999.
31. Funakoshi Y, Ichiki T, Itok, et al. Induction of intedeukin-6 expression by angiotensin Ⅱ in rat vascular smooth muscle cells[J]. Hypertension, 1999, 34:118—125.
32. Verma S, Li SH, Badiwala MV, et al. Endothelin antagonism and interleukin-6 inhibition attenuate the proatherogenic effects of C-reactive protein[J]. Circulation, 2002, 105: 1890—1896.
33. Vasan Ramachandran S, Sullivan Lisa M, Roubenoff Ronenn, et al. Inflammatory marlers and risk of heart failure in elderly subjects without prior myocardial infarction: The Framingham Heart Study[J]. Circulation, 2003, 107(11): 1486-1491
34. 摘自N. Seppa: Science News, Vol.164.December 13.2003, 373.
35. Alonso-Martinez JL, Llorente-Diez B.C-reactive protein as a predictor of improvement and readmisson in heart failure[J]. Eur J Heart Fail, 2002, 4(3): 331-336.
36. Misao J, Hayakawa Y. Expression of bcl-2 protein, an inhibitor of apoptosis, and bax, an accelerator of apoptosis, in ventricular myocytes of human heart with myocardial infarction[J]. Circulation, 1996, 94(7): 1506-1512.
37. Vasan RS, Sullivan LM.Inflammatory markers an ubjects without priormyocardial infarction[J]. The Framingham Heart Study Circulation, 2003 Mar 25, 107(11): 1486-1491.
38. Vasan Ramachandran S, Sullivan Lisa M, Roubenoff Ronenn, et al. Inflammatory marlers and risk of heart failure in elderly subjects without prior myocardial infarction: The Framingham Heart Study[J]. Circulation, 2003,107(11): 1486-1491.
39. Chung MK, Martin DO, Sprecher D, et al.C-reactive protein elevation in patients with atrial arrhythmias: Inflammatory mechanisma and persisitence of atrial fibrillation. Circulation, 2001,104: 2886-2891.
40. Dernellis J, Panaretou M.C-reactive protein and paroxysmal atrial fibrillation: evidence of the implication of an inflammatory process in paroxysmal atrial fibrillation[J].Acta Cardiol, 2001, 56: 375-380.
41. Cosin-sales J, Pizzi C, Brown D, et al.C-reactive protein, clinical presentation, and ischemic activity in patients with chest pain and normal coronary angiograms.J Am Coll Cardiol, 2003,41(9): 1468-1474.
2．王薇，赵冬，刘静，等．中国35～64岁人群心血管病危险因素与发病危险的前瞻性研究．中华心血管病杂志，2003，31：902-908．
3. Rioufol G, Finer G, AndreoFouet X, et al. Multiple ruptures of at herosclerotic plaques in acute coronary syndrome. Endocoronaryult rasonography study of three arteries. Arch Mal Coeur Vaiss, 2002, 95: 157-165.
4. Naghavi M, Libby P, Falk E, et al. From vulnerable plaque to vulnerable patient: a call for new definitions and risk assessment strategies: Part Ⅰ. Circulation, 2003, 108: 1664-1672.
5. Naghavi M, Libby P, Falk E, et al. From vulnerable plaque to vulnerable patient: a call for new definitions and risk assessment st rategies: Part Ⅱ. Circulation, 2003, 108: 1772-1778.
6. Koukkunen H, Penttilak, Kemppainen A, et al. C-reactive protein fibrinogen interleukin-6 and tumor necrosis factor-alpha in the nrognosic classification of unstable angina pectors[J]Am Med, 2001, 33: 37.
7. Jose L Tortes, Paul M Ridker. clinical use of high sensitivity C- reactive protein for the prediction of adverse cardiovascular events[J].Current Opinion in Cardiology, 2003, 18: 471.
8. Lagrand WK, Visser CA, Hermens WT, et al. Coreactive protein as a cardiovascular risk factor: more than an epiphenomenona[J] ? Circulation, 1999, 100(1): 96-102.
9. Penn MS, Topoi EJ. Tissue factor, the emerging link between inflammation, thrombosis, and vascular remodeling.Cir Res, 2001, 89(1): 122.
10. Pasceri V, Willerson JT, Yeh ET. Direct proin flammatory effect of C-reactive protein on human endothelial cells.Circulation, 2000, 102(18): 2165-2168.
11. Yasojima K, Schwab C, McGeer EG. Generation of C-reactive protoin. and complement components in atherosclerotic plaques. Am J Pathol, 2001, 158(3): 1039-1051.
12. Ridker PM, Hennckens CH, Sclhub J, et al. C-reactive protein and its relation to cardiovascular risk factors: a population-based cross-sectional study[J]. BMJ, 1996, 312: 1061-1065.
13. Ridker PM, Cushman M, Stampfer M J, et al. Inflammation, aspirin and the risk of cardiovascular disease in apparently healthy men[J].N Eng J Med, 1997, 336: 973-979.
14. Roberts WL, Moulton L, Law TC, et al. Evaluation of nine automated high-sensitivity C-reactive protein methods: implications for clinical and epidemiological applications. Part 2.Clin Chem, 2001, 47: 418-425.
15. Ridker PM. High-sensitivity C-reactive protein: potential adjunct for global risk assessment in the primary prevention of cardiovascular disease. Circulation, 2001, 103: 1813-1818.
16. Mendall MA, Strachan DP, Butland BK, et al. C-reative protein: relation to total mortality, cardiovascular mortality and cardiovascular risk factors in men[J]. Eur Heart J, 2000, 21: 1584-1590.
17. Morrow DA, Ridker PM. C-reactive protein, inflammation and coronary risk[J]. Med Clin North Am, 2000, 84: 149-161.
18．黄先勇，李玉芳，沈洪，等．C-反应蛋白水平与急性心肌梗死溶栓患者预后的临床研究[J]．中华老年心脑血管病杂志，2001，3：387-389．
19. Wu JT, Wu LL. Linking inflammation and atherogenesis: Soluble markers identified for the detection of risk factors and for early risk assessment.Clinica chimica Acta, 2006, 366: 74-80.
20. Madamanchi NR, Vendrov A, Runge MS. Oxidative stress and vascular disease. Arterioscler Thromb Vasc Biol, 2005, 25: 29-38.
21. Bobryshev YV. Monocyte recruitment and foam cell formation in atherosclerosis. Micron, 2006, 37: 208-222.
22. Rodriguez-Granillo GA, Aoki J, Ong AT, et al. Methodological considerations and approach to cross-technique comparisons using in vivo coronary plaque characterization based on intravascular ultrasound radiofrequency data analysis: insights from the Integrated Biomarker and Imaging Study (IBIS). Int J Cardiovasc Intervent, 2005, 7(1): 52-8.
23. Koukkunen H, Penttila K, Kemppainen A, et al. C-reactive protein, fibrinogen, interleukin-6 and tumour necrosis factor-alpha in the prognostic classification of unstable angina pectoris. Ann Med, 2001, 33(1): 37-47.
24．周朝霞，马爱群，强华，等．血清可溶性CD40配体对急性冠状动脉综合征的诊断．西安交通大学学报，2006，27(1)：2-4．
25．胡厚源，宋治远，张永克，等．16层螺旋CT冠状动脉显像在冠心病诊断中的应用．重庆医学，2006，35(3)：212-213．
26．中华医学会心血管病学分会，中华心血管病杂志编辑委员会．急性心肌梗死诊断和治疗指南．中华心血管病杂志，2001，29：710-725．
27．中华医学会心血管病学分会，中华心血管病杂志编辑委员会．不稳定性心绞痛诊断和治疗建议．中华心血管病杂志，2000，28：409-412．
28．中国高血压防治指南修订委员会．2004年中国高血压防治指南(实用本)．中华心血管病杂志，2004，32：1060-1064．
29. Thompson D, Pepys MB, Wood SEThe physiological structure of human C-reactive protein and its complex with phosphocholine.Structure Fold Des, 1999, 7:169-177.
30. Clyne B, Olshaker JS. The C-reactive protein. J Emerg Med, 1999, 17(6): 1019-1031.
31. Pearson TA, Mensah GA, Alexander RW, et al. Markers of inflammation and cardiovascular disease: application to clinical and public health practice: a statement for healthcare professionals from the Centers for Disease Control and Prevention and the American Heart Association.Circulation, 2003, 107:499-511.
32. Elkind MSV. Inflammation, Atherosclerosis, and Stroke(review). The Neurologist, 2006, 12(3):140-148.
33. Ford ES, Giles WH. Serum C-reactive protein and self-reported stroke: findings from the Third National Health and Nutrition Examination Survey. Arterioscler Thromb Vasc Biol, 2000, 20: 1052-1056.
34. Tortes JL, Ridker PM. Clinical use of high sensitivity C- reactive protein for the prediction of adverse cardiovascular events. Curr Opin Cardiol, 2003, 18(6): 471-478.
35. de Winter RJ, Fischer J, Bholasingh R, et al. C-reactive protein and cardiac troponin T in risk stratification: differences in optimal timing of tests early after the onset of chest pain. Clinical Chemistry, 2000, 46(10): 1597-1603.
36. Piechota W, Piechota W. Correlation of high-sensitivity CRP concentration with the extent of coronary atherosclerosis in men with symptoms of ischemic heart disease[Article in Polish]. Pol Merkuriusz Lek. 2005, 18(107): 511-515.
37. Bolad I, Delafontaine P. Endothelial dysfunction: its role in hypertensive coronary disease. Curr Opin Cardiol, 2005, 20; 270-274.
38. Liu YJ, Li XH. Clinical progress of color Doppler ultrasound evaluating invasion of vascular endothelial function. Chin J Med Imaging Technol, 2003, 19(2): 240-241.
39．中华医学会耳鼻咽喉科学分会，中华耳鼻咽喉科杂志编委会．阻塞性睡眠呼吸暂停低通气综合征诊断依据和疗效评定标准暨悬雍垂腭咽成形术适应证(杭州)．中华耳鼻咽喉科杂志，2002，37(6)：403-404．
40. Celermajer DS, Sorensen K, Ryalls M, et al.Non-invasive detection of endothelial dysfunction in children and adults at risk of atherosclerosis. Lancet, 1992, 340: 1111-1115.
41. Hirsch AT. Vascular disease, hypertension, and prevention: "from endothelium to clinical events"[J].JACC, 2003, 42(2): 377-379.
42. Pagnin E, Giacon V, Zaghetto F, et al. Arterial hypertension and oxidative stress induced by cyclosporin effect of carvedilol[J].Ann ItalMed Int, 2001, 16(2): 101-105.
43．刘磊，郑振声，钱学贤，等．高血压患者与正常血压者皮肤微血管对乙酰胆碱和硝普钠反应性比较[J]．高血压杂志，2002，9(3)：187-190．
44. Higashi Y, Oshima T, Sasaki S, et al. Angiotensin-converting enzyme inhibition, but not calcium antagonism, improves a response of the renal vasculature to L-arginine in patients with essential hypertension[J]. Hypertension, 1998, 32:16-24.
45．李轶男，央瑞英，袁洪，等．老年高血压病患者VWF、GMP-140、LRP含量的研究[J]．心血管康复医学杂志，2001，10(1)：24-26．
46．桂鸣，黄峻，王海燕，等．非侵入法对高血压早期血管内皮功能障碍的评价．中国动脉硬化杂志，2003，11：242-244．
47．李卫萍，孙明，周宏研．高血压患者血管内皮依赖性舒张功能与血清一氧化氮和超氧化歧化酶的关系．中国动脉硬化杂志，2003，11：155-158．
48．中华医学会糖书尿病分会代谢综合征协作组．中华医学会糖尿病分会关于代谢综合征的建议[J]．中华糖尿病杂志，2004，12(3)：156-161．
49. Grundy SM, Brewer B, Cleeman Jl, et al.Definition of metabolic syndromelreport of the National Heart, Lung, and Blood Institute/ American Heart Association conference on scientific issues related to definition.Circulation, 2004, 109: 433.
50. Eckel R, Grundy SM, Zimmet PZ.Metabolic syndrome.Lancet, 2005, 365: 1415.
51. Dandona P, Aljada A, Chaudhuri A, et al.Metabolic syndrome: a comprehensive perspective based on interactions between obesity, diabetes, and inflammation. Circulation, 2005, 11: 1448.
52. Evans RM, Barish GD, Wang YX.PPARs and complex journey to obesity. Nat Med, 2004, 10: 1.
53．周北凡，阳丰，赵连成，等．我国中年人向心性肥胖和心血管危险因素及其聚集性[J]．中华心血管病杂志，2001，29(2)：70-73．
54. Forouhi NG, Sattar N, M cKeigue PM.Relation of C-reactive protein to body fat distribution and features of themetabolic Syndrom in Europeans and South A sians[J].Int J Obes Relat Metab Disord, 2001, 25(9): 1327-1331.
55．邹大进，李慧．肥胖，炎症与胰岛素抵抗[J]．国外医学内分泌学分册，2004，24(4)：附录223．
56. Hashimoto M, Akishita M, Eto M et al.The impairment of flow-mediated vasodilatation in obese men with visceral fat accumulation.Int J Obes Relat Metab Disord, 1998, 22(5): 477.
57. Das UN.Is obesity an inflammatory condition Nutrition? 2001, 17: 953-966.
58．汪冀，牛峰海，寻文龙，等．单纯性肥胖儿童内分泌功能和内皮依赖性舒张功能的研究[J]．中华儿科杂志，2000，38(7)：414-416．
59．孙明晓，迟家敏．肥胖与2型糖尿病．中国医刊，2005，40(1)：13-16．
60．戚丽，路中，董砚虎．糖尿病心血管病变的研究进展．国外医学内分泌学分册，2004，24(1)：71-72．
61．祝之明．代谢综合征的诊断和治疗．中华心血管病杂志，2004，32(12)：1163-1166．
62．邢小燕，杨文英．减重后体重反弹的防治策略．国外医学内分泌学分册，2005，25(1)：729．
63．邹大进．超重和肥胖——代谢综合征的主要病因．国外医学内分泌学分册，2005，25(3)：145-147．
64. Tamar S, Giora P.Sleep apnea in the older adult.Drugs Aging, 2003, 20:551-560.
65. Bixler EO, Vgontzas AN, Ten Have T, et al. Effects of age on sleep apnea in men: I. Prevalenca and severity. Am J Respir Crit Care Med, 1998, 157(1): 144-184.
66. Leeuw PW. On Sleep and death: Cardiovascular risk of the obstructive sleep apnea syndrome[J].Neth J Med, 1999, 54:188-190.
67. Parra O, Josep M, Adria Arboix, et al. Time course of sleep related breathing disorders in first-ever stroke or transient ischemic attack[J].Am J Respir Crit Care Med, 2000, 161: 375-380.
68. Wessendorf TE, Teschler H, YM Wang, et al. Sleep-disordered breathing among patients with first-ever stroke[J].J Neurol, 2000, 247: 41-47.
69. Nobili L, Schiavi G, Bozane E, et al. Morning increase of whole blood viscosity in obstructive sleep apnea syndrome[J]. Clin Hemorheol Microcirc, 2000, 22: 21-27.
70. Richard A, Ansarin K, Baran AS. Sleep apnea and hypertension: pathophysiologic mechanisms. Semin Nephrol.2002, 22: 71-77.
71. Shamsuzzaman AS, Winnicki M, Lanfranchi P, et al.Elevated C-reactive protein in patients with obstructive sleep apnea.Circulation, 2002, 105: 2462-2464.
72. Yokoe T, Minoguchi K, Mat suo H. Elevated levels of C-Reactive protein and interlrukin-6 in patients with obstructive sleep apnea syndrome are decreased by nasal continuous positive airway pressure. Circulation, 2003, 107(8): 1129-1134.
73. Good friend TL, Calhoun DA. Resistant hypertenion, obesity Sleep apnea and aldosterone: thory and therapy.Hypertension, 2004, 43:518-524.
74. Shamsuzzaman AS, Gersh BJ, Somers VK. Obstructive sleep apnea: implications for cardiac and vascular disease. JAMA, 2003, 290:1906-1914.
75．王毓洲．阻塞性睡眠呼吸暂停／低通气综合征的发病机理[J]．中国全科医学，2002，5(3)：178-179．
76．张希龙，童茂容，夏锡荣，等．鼾症老年人睡眠呼吸暂停症与心血管疾病的相关性[J]．中华老年心脑血管病杂志，2001，3(3)：150-152．
77. Kraiczi H, Caidahl K, Samuelsson A, et al. Impairment of vascular endothelial function and left ventricular filling: association with the severity of apnea-induced hypoxemia during sleep[J]. Chest, 2001, 119: 1085-1091.
78. Leung RST, Bradley TD. Sleep apnea and cardiovascular disease [J]. Am J Respir Crit Care Med, 2001, 164: 2147-2165.
79. Schafer H, Kohler U, Ploch T, et al.Coronary heart disease and upper airway obstruction[J].J Sleep Res, 1995,4(S1): 185-189.
80. Koehler V, Schafer H.Is obstructive sleep apnea a risk factor for myocardial infarction and cardiac arrhythmias in patients with coronary heart disease.Sleep, 1996, 19: 283-286.
81. Ip MS, Lam B, Ng MM, et al.Obstructive sleep apnea is independently associated with insulin resistance[J].AM J Respir Crit Care med 2002,165(5), 670-676.
1. Tillett WS, Fraecis T.Serological reactions in pneumonia with a nonprotein somatic of the pneumococcus[J]. JEXP Med 1930, 52(4): 561-571.
2. Thompson D, Pepys MB, Wood SEThe physiological Structure of human C-reactive protein and its complex with phosphocholine[J]. Structure Fold Des, 1999, 7(2): 169-177.
3. Clyne B, Olshaker JS.The C-reactive protein[J]. J Emerg Med, 1999, 17(6): 1019.
4．李建军．C-反应蛋白与冠心病的关系[J]．中国循环杂志，1994，14(5)：319．
5. Roberts WL, Mouton L, Law TC, et al.Evluation of nine anomataed high sensitivity C-reactive protein methods: implications for clinical and epidemio logical applications[J]. Clin Chem, 2001, 47:418-423.
6. Ross R. The pat hogenesis of at herosclerosis: a perspective for the 1990s[J]. Nature, 1993, 362: 801-2809.
7. Cooke JP. The endothelium: a new target for therapy[J]. VascMed, 2000, 5: 49—43.
8. Maseri A. Inflammation atheroseclerosis and ischemic events- exploring the hidden side of the moon[J]. N Engl J Med, 1997, 336: 1014.
9. Jose L Torres, Paul M Ridker. clinical use of high sensitivity C- reactive protein for the prediction of adverse cardiovascular events[J].Current Opinion in Cardiology, 2003, 18: 471.
10．胡大一，王宏宇，倪永斌．大动脉功能与心血管疾病[M]．北京：人民军医出版社，2003：94．
11. Ridker Paul M, Nader, Rifai, et al.Comparison of C-reactive protein and low-density lipoprotein cholesterol levels in the prediction of first cardiovascular events[J]. N Engl J Med, 2002, 347: 1557—1565
12. Paul M Ridker, Julie E Buring, Nancy R, et al.C-reactive protein, the Metabolic Syndrome, and risk of incident cardiovascular events: A 8-year follow-up of 14719 initially healthy American women[J]. Circulation, 2003, 107:391—397
13. Levine GN, Keaney J F, Vita JA. Cholesterol reduction in cardio- vascular disease.Clinical benefits and possible mechanisms[J]. N Engl J Med, 1995, 332(8): 512-521.
14. Celermajer DS, Sorensen KE, Gooch VM, et al. Noninvasive detection of enedothelial dysfunction in children and adults at task of atherosclerosis[J].Lancet, 1992, 340: 1111-1115.
15. Deng YB, Li TL, Xiang HJ, et al. Impaired endothelial function in the brachial artery after Kawasaki disease and the effects of intravenous administration of vitamin C[J]. Pediatr Infect Dis J, 2003, 22(1): 34-39.
16. Koenig W, Sund M, Froblich M, et al. C-reactive protein, a sensitive marker of inflammation, predicts future risk of coronary heart disease in initially healthy middle-aged men: results from the MONICA(Monitoring Trends and Determinants in Cardiovascular Disease) Augsburg Cohort Study, 1984 to 1992[J].Circulation, 1999, 99(2): 237—242.
17. Ridker Paul M. Clinical Application of C-reactive Protein for Cardiovascular disease Detection and Prevention[J]. Circulation, 2003, 107:363—369.
18. Pearson TA, Mensah G, Alexander RW, et al. Markers of inflammation and cardiovascular disease: Application to clinical and public health practice: A statement for healthcare professionals from the centers for Disease Control and Prevention and the American Heart Association[J]. Circulation, 2003, 107: 499—511.
19. Haver kate F, Hompson SG, Pyke SD, et al.Production of Coronary events in stable and unstable angina[J].Lancet, 1997, 349(9050): 462-466.
20．李崇剑，徐耕，傅国胜，等．血清C-反应蛋白与冠心病危险因素及冠状动脉病变的关系分析．中国循环杂志，2003，18：443．
21．朱士洲，急性心肌梗死患者C-反应蛋白含量与梗死面积和部位的关系[J]．临床心血管杂志，2003，19(11)：685-686．
22. Marrow DA, Rifai N, Antman EM, et al. C-reactive protein is a potent predictor of mortality independently of and in combination with troponin T in acute coronary syndromes: a TIMI Ⅱ A substudy[J]. J am Coll Cardiol, 1998, 31: 1460-1465.
23. Ueda S, Ikeda U, Yamamotok, et al. C-reactive protein as a predictor of cardiac rupture after acute myocardial infarction[J]. Am Heart J, 1996, 131: 1460-1465.
24. Anzai T, Yashikawa T, Kaneko H, et al. Association between serum C-reactive protein elevation and left ventriculor thrombus formation after frist anterior myocardial infarction[J]. Chest, 2004, 125(2): 384-389.
25．李崇剑，徐耕．急性冠脉综合征的生化标志物研究进展[J]．心血管病学进展，2002，22(6)：345-347．
26．蒋利，沈卫峰，张建成，等．C-反应蛋白对冠状动脉内支架术预后的预测价值[J]．中华心血管病杂志，2003，31(1)：45．
27．冯文文，钱菊英，周明成，等．血清C-反应蛋白对冠状动脉支架置入术后心血管事件和再狭窄的预测价值[J]．中华心血管病杂志，2003，31(7)：514-516．
28．于力，刘怀霖，赵亚军，等．急性心肌梗死发病6h内C-反应蛋白的检测及临床意义[J]．临床内科杂志，2002，19(1)：16-17．
29. Leonelo E Bautista, Patricio Lopez-Jaranillo, Lina M Vera, et al. Is C-reactive protein an independent risk factor for essential hypertension? [J]. Hypertension, 2001, 19:587—861.
30. Blake Gavin J, Rifai Nader, Buring Julie E, et al. Blood Pressure, C-Reactive Protein, and Risk of Future Cardiovascular Events[J].Circulation, 2003, 108(24): 2993—2999.
31. Funakoshi Y, Ichiki T, Itok, et al. Induction of intedeukin-6 expression by angiotensin Ⅱ in rat vascular smooth muscle cells[J]. Hypertension, 1999, 34:118—125.
32. Verma S, Li SH, Badiwala MV, et al. Endothelin antagonism and interleukin-6 inhibition attenuate the proatherogenic effects of C-reactive protein[J]. Circulation, 2002, 105: 1890—1896.
33. Vasan Ramachandran S, Sullivan Lisa M, Roubenoff Ronenn, et al. Inflammatory marlers and risk of heart failure in elderly subjects without prior myocardial infarction: The Framingham Heart Study[J]. Circulation, 2003, 107(11): 1486-1491
34. 摘自N. Seppa: Science News, Vol.164.December 13.2003, 373.
35. Alonso-Martinez JL, Llorente-Diez B.C-reactive protein as a predictor of improvement and readmisson in heart failure[J]. Eur J Heart Fail, 2002, 4(3): 331-336.
36. Misao J, Hayakawa Y. Expression of bcl-2 protein, an inhibitor of apoptosis, and bax, an accelerator of apoptosis, in ventricular myocytes of human heart with myocardial infarction[J]. Circulation, 1996, 94(7): 1506-1512.
37. Vasan RS, Sullivan LM.Inflammatory markers an ubjects without priormyocardial infarction[J]. The Framingham Heart Study Circulation, 2003 Mar 25, 107(11): 1486-1491.
38. Vasan Ramachandran S, Sullivan Lisa M, Roubenoff Ronenn, et al. Inflammatory marlers and risk of heart failure in elderly subjects without prior myocardial infarction: The Framingham Heart Study[J]. Circulation, 2003,107(11): 1486-1491.
39. Chung MK, Martin DO, Sprecher D, et al.C-reactive protein elevation in patients with atrial arrhythmias: Inflammatory mechanisma and persisitence of atrial fibrillation. Circulation, 2001,104: 2886-2891.
40. Dernellis J, Panaretou M.C-reactive protein and paroxysmal atrial fibrillation: evidence of the implication of an inflammatory process in paroxysmal atrial fibrillation[J].Acta Cardiol, 2001, 56: 375-380.
41. Cosin-sales J, Pizzi C, Brown D, et al.C-reactive protein, clinical presentation, and ischemic activity in patients with chest pain and normal coronary angiograms.J Am Coll Cardiol, 2003,41(9): 1468-1474.
© 2004-2018 中国地质图书馆版权所有 京ICP备05064691号 京公网安备11010802017129号 地址：北京市海淀区学院路29号 邮编：100083 电话：办公室：(+86 10)66554848；文献借阅、咨询服务、科技查新：66554700 |