CRP由肝細(xì)胞合成并且受到幾種細(xì)胞因子的轉(zhuǎn)錄調(diào)控,如白細(xì)胞介素(IL)-6、IL-1、腫瘤壞死因子、干擾素等2。也有證據(jù)表明CRP可能在動脈粥樣硬化病變的血管平滑肌細(xì)胞(SMC)和巨噬細(xì)胞中局部產(chǎn)生。關(guān)于CRP本身是否是動脈粥樣硬化血栓形成的致病因素一直存在爭議。就現(xiàn)有的數(shù)據(jù)可以表明五聚體CRP主要是心血管疾病的生物標(biāo)志物,而不是致病因素。該數(shù)據(jù)強(qiáng)調(diào)了將上游炎癥介質(zhì)作為心血管疾病的潛在治療方法的重要性3。
高敏C-反應(yīng)蛋白(hsCRP)
美國心臟協(xié)會(AHA)和疾病控制與預(yù)防中心(CDC)在對炎癥標(biāo)志物與心血管疾病之間的關(guān)聯(lián)進(jìn)行系統(tǒng)評估后,建議將hsCRP作為預(yù)測心血管疾病的標(biāo)志物4-6。高敏CRP(hsCRP)與CRP是同一種蛋白。hsCRP在低濃度(1-10mg/L)范圍內(nèi)具有更高的敏感性和準(zhǔn)確性,而常規(guī)CRP的可檢測范圍一般為10-200mg/L,其彌補(bǔ)了常規(guī)CRP的檢測范圍的局限性以及提高心血管疾病預(yù)測的潛在風(fēng)險性。AHA/CDC對心血管疾病風(fēng)險評估指南如下:hsCRP水平<1 mg/L,低風(fēng)險;1 mg/L<hsCRP水平<3 mg/L,中等風(fēng)險;hsCRP水平>3 mg/L,高風(fēng)險3,6。
參考文獻(xiàn)
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