血清妊娠相关蛋白A水平对代谢综合征患者预后评价

目的探讨血清妊娠相关蛋白A(PAPP-A)水平对代谢综合征(MS)患者危险分层和预后判断的价值。方法测定120例MS患者血清PAPP-A水平,根据检测的血清PAPP-A水平,以PAPP-A水平的75%百分位数值作为分界点,分为高PAPP-A水平组和低PAPP-A水平组,各组随访6个月,报告主要急性心血管事件发生率(包括不稳定型心绞痛、非致命性心肌梗死)及发生急性心血管事件后行经皮冠状动脉介入治疗(PC I)或冠状动脉旁路移植术(CABG)进行血运重建及死亡发生情况。结果随访期间无死亡病例。高PAPP-A水平组发生急性心血管事件8例,其中7例行PC I治疗,1例行CABG治疗,急性心血管事件发生率为26.7%(8/30);低PAPP-A水平组发生急性心血管事件3例,其中2例行PC I治疗,无CABG治疗者,急性心血管事件发生率为3.33%(3/90),高PAPP-A水平组急性心血管事件发生率明显高于低PAPP-A水平组(P<0.05)。随着血清PAPP-A水平的升高,6个月急性心血管事件的发病危险性随之上升,2组之间存在正向中等强度联系(OR=3.62,95%CI=1.83~6.21,P<0.05)。结论血清PAPP-A水平可作为MS患者有价值的预测指标,对筛选MS患者中高危患者具有重要意义。

Prognostic evaluation of pregnancy-associated plasma protein A level in patients with metabolic syn-drome

Objective To investigate the value of pregnancy-associated plasma protein-A （PAPP-A） level for the risk stratify and prognosis of the metabolic syndrome（MS） patients. Methods The levels of serum PAPP-A of 120 patients with metabolic syndrome were examined. The high PAPP-A group and the low PAPP-A group were divided according to the level of PAPP-A. The follow-up period was six months. And the adverse cardiovascular events include unstable angina,non-fatal myocardial infarction,the treatment of coronary, artery interventional therapy（PCl） and coronary artery bypass grafting（CABG） for the adverse cardiovascular events,the condition of revaseularization and death were recorded. Results There was no death during follow-up period. In high PAPP-A group,eight cases underwent adverse cardiovascular events,there were seven cases received PCI and one case received CABG. The rate of adverse cardiovascular events in high PAPP-A group was 26.7% （8/30）. In low PAPP-A group, three cases underwent adverse cardiovascular events, there were two cases received PCI and none received CABG,the rate was 3.3% （3/90） ,The incidence of CVD in high PAPP-A group was higher that that in low PAPP-A group（ P 〈 0.05 ）. With the level of PAPP-A increasing,the risk of adverse cardiovascular events in six months was also increased,there was positive and medium intensity relationship between two groups （ OR = 3.62,95% CI = 1.83 - 6.21 , P 〈 0. 05 ）. Conclusion PAPP-A can be used as a valuable predictor for MS patient＇s risk of the adverse events,so it is important for screening high-risk patients with MS.