急性冠状动脉综合征患者血清可溶性细胞间粘附分子1和妊娠相关血浆蛋白A的变化

目的观察急性冠状动脉综合征患者血清可溶性细胞间粘附分子1、妊娠相关血浆蛋白A水平的变化,结合冠状动脉造影结果探讨其临床意义。方法用酶联免疫吸附法检测46例急性冠状动脉综合征患者(其中急性心肌梗死20例,不稳定型心绞痛26例)、22例稳定型心绞痛患者和20例冠状动脉造影阴性对照者血清可溶性细胞间粘附分子1、妊娠相关血浆蛋白A水平,分析冠状动脉病变程度与可溶性细胞间粘附分子1、妊娠相关血浆蛋白A浓度的关系。结果急性冠状动脉综合征组血清可溶性细胞间粘附分子1和妊娠相关血浆蛋白A浓度较稳定型心绞痛组、对照组显著升高(P<0.05或P<0.01)。冠状动脉造影为单支、双支、三支病变者,其可溶性细胞间粘附分子1、妊娠相关血浆蛋白A浓度依次增高。相关分析发现,急性心肌梗死、不稳定型心绞痛患者血清可溶性细胞间粘附分子1浓度与妊娠相关血浆蛋白A浓度显著正相关(r=0.737和r=0.758,P<0.001)。结论急性冠状动脉综合征患者可溶性细胞间粘附分子1、妊娠相关血浆蛋白A升高,二者可能是动脉粥样斑块不稳定的标志。

Changes of the Levels of Serum Soluble Intercellular Adhesion Molecule-1 and Pregnancy Associated Plasma Protein-A in Patients with Acute Coronary Syndrome

Aim To observe the changes of soluble intercellular adhesion molecule-1(sICAM-1) and pregnancy associated plasma protein-A(PAPP-A) levels and to explore its clinical value combining with coronary angiography(CAG) results in patients with acute coronary syndrome(ACS). Methods The levels of serum sICAM-1 and PAPP-A were measured with enzyme linked immunosorbent assay(ELISA) in 46 patients with ACS,22 with stable angina pectoris(SAP) and 20 coronary angiography negative as controls.The results of the three groups and different numbers of diseased coronary vessels in coronary heart disease(CHD) group were analyzed. Results sICAM-1 in ACS group was significantly higher than that in SAP group(P<0.05) and control group(P<0.01),PAPP-A in ACS group was significantly higher than that in SAP group and control group(P<0.01).The sICAM-1 and PAPP-A concentrations were increased in the 1-vessel-disease group,the 2-vessel disease group,and the 3-vessel-disease group.In patients with acute myocardial infarction(AMI) and unstable angina pectoris(UAP),there were obvious correlations between sICAM-1 and PAPP-A(r=0.737,and r=0.758,P<0.001). Conclusions The levels of sICAM-1 and PAPP-A increased in ACS patients,which may reflect the instability of atherosclerotic plaques.