妊娠相关血浆蛋白-A与急性冠脉综合征相关性研究

目的对比冠心病不同亚组患者血清妊娠相关血浆蛋白-A(PAPP-A)表达的变化,并对PAPP-A与各临床指标进行相关性分析。方法采用酶联免疫吸附法测定不稳定型心绞痛病人(UAP,n=37),急性心肌梗塞病人(AMI,n=24),稳定型心绞痛病人(SAP,n=29),健康体检者(n= 32)的PAPP-A水平;同时测定病人及健康体检者的磷酸肌酸激酶(CK)、磷酸肌酸激酶同功酶(CK- MB)、肌钙蛋白(cTnI)、高敏C反应蛋白(hs-CRP)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL)、低密度脂蛋白胆固醇(LDL)、血压、血糖水平,且对上述人群进行冠状动脉造影检查。结果PAPP-A在UAP、AMI病人比SAP、健康体检者显著升高(P<0.01),PAPP-A与hs-CRP水平呈正相关(P≤0.05),而与CK、CK-MB、cTnI没有显著相关性(P>0.05);与年龄、血脂、血糖、血压等冠心病危险因素,以及冠脉病变支数、冠脉狭窄程度无明显相关性(P>0.05)。结论PAPP-A水平与动脉粥样硬化斑块的不稳定密切相关,可作为ACS新的生化指标用于临床的预测和诊断。

Correlation study between Pregnancy-Associated Plasma Protein-A and Acute Coronary Syndrome

Objective To contrast the changes of the pregnancy-associated plasma protein-A (PAPP-A)expression in Coronary Heart Disease subgroups,and the correlation analysis between PAPP-A and varying clinical indices were conducted.Methods It was measured circulating levels of PAPP-A,CK, CK-MB,cTnI,hs-CRP,TC,TG,HDL,LDL,etc.in 37 patients with unstable angina( UAP),24 patients with acute myocardial infarction(AMI),29 patients with stable angina(SAP),and 32 healthy persons were taken as control group .In addition ,these people had undergone coronary arteriography.Results The PAPP-A in patients with acute coronary syndromes was significantly higher than that in patients with stable angina and controls(P<0.01 ).The cireulating level of PAPP-A was correlating with hs-CRP,but not with CK,CK-MB,cTnI,age,blood pressure,blood glucose,TC,TG,HDL,LDL,numbers of coronary vessel disease and the stenosis degrees of coronary vessel.Conclusions PAPP-A may be a newly sensitive marker for indentifying patients with ACS.