冠心病患者血清PAPP-A、PC、hs-CRP水平与冠脉病变程度及预后的相关性研究

目的探讨冠心病(CHD)患者血清妊娠相关血浆蛋白A(PAPP-A)、血浆蛋白C(PC)、超敏C反应蛋白(hs-CRP)水平变化及其与冠脉病变程度、预后的关系。方法研究对象源于2017年10月至2018年10月本院收治的186例CHD患者(纳为疾病组)和同期健康体检志愿者85名(纳为对照组),比较两组血清PAPP-A、PC、hs-CRP水平,冠脉造影评估CHD患者冠脉病变程度,随访疾病组预后,分析不同冠脉病变、不同预后CHD患者血清PAPP-A、PC、hs-CRP水平变化,并进行相关性分析。结果与健康组比较,疾病组血清PAPP-A、hs-CRP水平明显升高,PC水平明显降低,差异具有统计学意义(P<0.05);随着冠脉病变程度加重,CHD患者血清PAPP-A、hs-CRP水平依次明显升高,PC水平依次明显降低,差异具有统计学意义(P<0.05);随访发现共42例发生MACE事件(22.58%),发生MACE事件的CHD患者血清PAPP-A、hs-CRP水平较未发生者明显升高,而PC水平明显低于未发生者,差异具有统计学意义(P<0.05);Pearson相关分析发现,CHD冠脉病变程度、预后与血清PAPP-A、hs-CRP呈明显正相关(r=0.546、0.607,P<0.05),与PC水平呈明显负相关(r=-0.512,P<0.05)。结论CHD患者血清PAPP-A、hs-CRP水平明显升高而PC明显降低,三者与CHD病情程度及预后密切相关,或可作为CHD危险分层和预后评估的有效指标。

The Correlations Between Serum PAPP-A,PC,hs-CRP Levels and Coronary Lesion Degree,Prognosis in Patients with Coronary Heart Disease

Objective To explore relationships between changes in levels of serum pregnancy-associated plasma protein A(PAPP-A),plasma protein C(PC)and high-sensitivity C-reactive protein(hs-CRP)and coronary lesion degree,prognosis in patients with coronary heart disease(CHD).Methods The study cohort were 186 CHD patients(the disease group)who were admitted to the hospital from October,2017 to October,2018 and 85 healthy volunteers(the control group)who underwent physical examination during the same period.The levels of serum PAPP-A,PC and hs-CRP were compared between the two groups.Coronary angiography was conducted to evaluate coronary lesion degree among CHD patients.The prognosis in the disease group was followed up.The changes in levels of serum PAPP-A,PC and hs-CRP among CHD patients with different coronary lesions and prognosis were analyzed.And a correlation analysis was conducted.Results Compared with the healthy group,levels of serum PAPP-A and hs-CRP were significantly higher in the disease group,while PC level was significantly lower(P<0.05).With exacerbation of coronary lesions,levels of serum PAPP-A and hs-CRP among CHD patients were significantly increased,while level of PC was significantly decreased in turn(P<0.05).The follow-up results showed that there were 42 cases(22.58%)with MACE.The levels of serum PAPP-A and hs-CRP in CHD patients with MACE events were significantly higher than those without MACE events,while PC level was significantly lower than that without MACE events(P<0.05).Pearson correlation analysis found that coronary lesion degree and prognosis were significantly positively correlated with serum PAPP-A and hs-CRP(r=0.546,0.607,P<0.05),while significantly negatively correlated with PC level(r=-0.512,P<0.05).Conclusion The levels of serum PAPP-A and hs-CRP are significantly increased,while PC is significantly decreased in CHD patients.The three are closely related to severity and prognosis of CHD,which can be applied as effective indexes for risk stratification and prognosis evaluation of CHD.