PA PP-A 的表达及基因多态性与冠心病患者冠状动脉病变程度的关系

目的：探讨妊娠相关血浆蛋白A（PAPP‐A）的表达及基因多态性与冠心病患者冠状动脉（以下简称冠脉）病变程度的关系。方法选取来河南省南阳市中心医院就诊的冠心病患者98例（观察组），根据冠脉造影检查结果将患者分为单支病变组和多支病变组。选取同期来该院健康体检者98例（对照组），分别于患者就诊时和对照组体检时抽取静脉血，采用ELISA法检测血清PAPP‐A的蛋白水平，聚合酶链式反应‐限制性片段长度多态性（PCR‐RFLP）检测PAPP‐A基因的IVS6＋95多态性。结果与对照组比较，观察组患者外周血PA PP‐A蛋白水平明显升高（ P＜0．05），而多支病变组患者外周血PA PP‐A蛋白水平明显高于单支病变组患者（P＜0．05）。外周血PAPP‐A水平与冠脉病变程度呈正相关。PAPP‐A基因IVS6＋95位点存在3种基因型，包括CG杂合型、CC纯合型和GG纯合型。其中多支病变患者CC纯合型位点基因频率明显高于单支病变组患者（ P＜0．05）。结论 PAPP‐A蛋白水平及IVS6＋95多态性与冠心病患者冠脉病变程度存在密切关系，CC基因型患者可能是冠心病患者遗传易感性基因标志之一。

Relationship between serum PAPP-A expression and gene polymorphism with severity of coronary lesions in patients with coronary heart disease

Objective To investigate the relationship between serum pregnancy associated plasma protein A (PAAA‐A) ex‐pression and gene polymorphism with the severity of coronary lesions in the patients with coronary heart disease (CHD) .Methods Ninety‐eight patients with CHD in the Nanyang Municipal Central Hospital were selected as the observation group and divided into single vessel lesion group and multiple vessel lesion group according to coronary angiographic results .Ninety‐eight individuals un‐dergoing healthy physical examination were selected as the control group .The venous blood was collected at the visiting hospital in the observation group and at the physical examination in the control group for detecting the serum PAPP‐A protein level by ELISA .PAPP‐A gene and IVS6+ 95 polymorphism were analyzed by adopting polymerase chain reaction restriction fragment length polymorphism(PCR‐RELP) .Results Compared with the control group ,peripheral blood PAPP‐A protein level in the obser‐vation group was significantly increased(P<0 .05) ,moreover the PAPP‐A protein level in the multiple vessel lesion group was sig‐nificantly higher than that of the single vessel lesion group (P<0 .05) .The peripheral blood PAPP‐A level was positively correlated with the severity of CHD .Three genotypes existed in PAPP‐A gene IVS6+95 locus ,including CG heterozygous ,homozygous CC and GG homozygous type .The CC homozygous allele frequency in the patients with multiple vessel lesion was higher than that in the patients with single vessel lesion (P<0 .05) .Conclusion The PAPP‐A protein level and IVS6+95 polymorphism have a close relation with the severity of coronary lesions in patients with CHD .CC genotype may be one of genetic susceptibility gene markers in the patients with CHD .