急性冠脉综合征血管内超声斑块显像与血清淀粉样蛋白A、妊娠相关蛋白A表达的相关性研究

目的：探讨急性冠脉综合征（ACS）患者血管内超声（IVUS）显像与血清淀粉样蛋白A（SAA）、妊娠相关血浆蛋白A（PAPP-A）浓度的相关性。方法：按照1979年WHO缺血性心脏病诊断标准选择80例住院冠心病患者,分为稳定型心绞痛（SAP）组（20例）和ACS组（60例）,所有患者均行IVUS、冠脉造影检查,术前至少1h分别检测患者血清SAA、血浆PAPP-A的浓度,并与IVUS检查所得出的斑块纤维帽厚度、偏心指数、重构指数比较,分析其相关性。结果：与SAP组患者相比,ACS组患者纤维帽厚度明显变薄（1.0±0.2）mm∶（0.7±0.1）mm],偏心指数（0.4±0.1）∶（0.9±0.2）]、重构指数明显提高（0.8±0.1）∶（1.3±0.2）],SAA（13.75±9.65）MIU/L∶（36.4±12.32）MIU/L]、PAPP-A（10.36±8.25）mg/L∶（32.68±12.5）mg/L]浓度明显升高（P均〈0.001）。SAA、PAPP-A水平与纤维帽厚度均呈负相关（r=-0.68,-0.68,P均〈0.05）,与偏心指数（r=0.75,0.81）、重构指数（r=0.71,0.78）呈正相关（P均〈0.05）。结论：急性冠脉综合征患者易损斑块的纤维帽厚度、偏心指数、重构指数（斑块稳定性）与血清淀粉样蛋白A、妊娠相关蛋白A存在相关关系,血清淀粉样蛋白A、妊娠相关蛋白A可作为预测易损斑块稳定性的重要指标。

Relationship between levels of serum amyloid protein A and pregnancy- associated plasma protein A and plaque image characteristics of acute coronary syndrome detected by intravascolar ultrasound

Objective: To explore the correlation between plaque image characteristics detected by intravascular ultrasound(IVUS) in patients with acute coronary syndrome(ACS) and levels of serum amyloid protein A(SAA) and pregnancy-associated plasma protein A(PAPP-A).Methods: According to WHO diagnostic standard of ischemic heart diseases(IHD)in 1979,a total of 80 IHD inpatients were enrolled and divided into stable angina pectoris(SAP) group(n=20) and ACS group(n=60).All patients underwent coronary angiograph(CAG) an...