冠心病患者妊娠相关血浆蛋白-A的水平及临床意义

目的：探讨妊娠相关血浆蛋白-A(PAPP-A)与冠心病发生、发展及血脂之间的关系。方法：冠心病组患者75例，包括急性心肌梗塞患者（AMI）32例、不稳定心绞痛（UAP）患者22例、稳定性心绞痛（SAP）患者21例及正常对照组60例。采用双抗体夹心酶联免疫吸附实验检测PAPP-A，采用双抗体放射免疫法检测IL-6，采用ABC-HRP方法测定IL-10，采用全自动生化分析仪测定血脂。结果：①PAPP-A在急性冠脉综合征（ACS，包括急性心肌梗塞、不稳定心绞痛）患者中浓度较稳定性心绞痛和正常对照组明显偏高(P<0.05)。②PAPP-A与血清总胆固醇（TC）、ApoA1/ApoB的浓度有明显相关性(r=0.348、-0.420，P<0.05)。③IL-6、IL-10浓度冠心病患者较正常对照明显偏高(P<0.05)；且在AMI、UAP、SAP组组间比较差异均有显著性（P<0.05）；PAPP-A与IL-6、 IL-10呈正相关（Spearman相关系数分别为0.446、0.523，P<0.05）。结论：PAPP-A与冠心病发生、发展关系密切，可作为冠心病粥样斑块不稳定性的重要标志。

Levels of pregnancy-associated plasma protein-A in patients with coronary heart diseases and clinic significance

Objective To explore the relationship between pregnancy-associated plasma protein-A(PAPP-A) and occurance,development of cardiovascular diseases,and lipids.Methods 75 patients with coronary disease were divided into acute myocardial infarction(n=32),unstable angina pectoris(n=22) and stable angina pectoris(n=21) groups,and 60 subjects without coronary diseases were used as controls.The serum PAPP-A,IL-6,IL-10,lipids were measured in all patients and controls by different methods of enzymatically amplified two-step sandwithtype immunoassay,double antibody radio-immunoassay,ABC-HRP,auto biochemistic analytist.Results ①The level of PAPP-A in acute coronary syndrome(ACS,including acute myocardial infarction and unstable angina pectoris) patients was significantly higher than that in stable angina pectoris patients and controls(P<0.05).(②There) were significantly associations between(PAPP-A) and serum totle cholesterol,ApoA1/ApoB(r=0.348,0.420,P<0.05).③The levels of IL-6 and IL-10 in coronary heart disease patients were significantly higher than those in controls(P<0.05),and the variations among acute myocardial infarction,unstable angina pectoris,stable angina pectoris patients were significantly(P<0.05).There were significantly associations between(PAPP-A),IL-6 and IL-10(Spearman r 0.446,0.523,P<0.05).Conclusion PAPP-A is significantly associated with occurance and development of coronary heart disease,probablely as a marker of unstable plaque in coronary heart disease.