妊娠相关血浆蛋白-A对急性冠脉综合征诊断价值的研究

目的 探讨妊娠相关血浆蛋白-A(PAPP-A)对急性冠脉综合征(ACS)患者的诊断价值.方法 选择49例经冠状动脉造影证实的心肌肌钙蛋白I(cTnI)阴性的冠心病患者.其中ACS患者31例(ACS组),稳定型心绞痛(SAP)患者18例(SAP组),另选择28例冠状动脉造影正常者作为对照组.采用酶联免疫吸附法检测各组血清PAPP-A和超敏C反应蛋白(hs-CRP)水平.结果 (1)ACS组PAPP-A和hs-CRP水平较SAP组、对照组均显著增高(P<0.05).(2)以PAPP-A 2.79μg/L作为ACS的阳性诊断标准,其灵敏度为81.0%,特异度为84.6%.ROC曲线下面积为0.9,95%可信区间为0.82-0.99.(3)ACS组hs-CRP水平与PAPP-A水平呈正相关(r=0.418,P<0.01).结论 PAPP-A可作为诊断ACS的指标之一,对于cTnI阴性的ACS患者尤其有价值.

The study on the diagnostic value of pregnancy-associated plasma protein-A in acute coronary syndrome patients

Objective To investigate the diagnostic value of pregnancy-associated plasma protein-A (PAPP-A) in acute coronary syndrome (ACS) patients. Methods Forty-nine cTnI-negative patients with coronary artery disease who were documented by angiography [31 cases with ACS,18 cases with stable angina (SAP)], and 28 healthy persons were selected as controls. PAPP-A and hs-CRP were analysed with enzyme-linked immunosorbent assay (ELISA). Results Circulating PAPP-A and ha-CRP levels were significandy higher in patients with ACS than those in patients with SAP and controls (P < 0.05). PAPP-A threshold value of 2.79 μg/ml identified patients who had ACS with a sensitivity of 81.0% and a specificity of 84.6%. PAPP-A levels were correlated with hs-CRP levels in patients with ACS (r = 0.418, P < 0.01). Conclusion PAPP-A is a strong candidate marker of ACS, especially to eTnl-negative patients.