妊娠相关性血浆蛋白-A在急性冠脉综合征患者中的临床意义

目的通过检测不同冠心病组及对照组外周血妊娠相关性血浆蛋白-A(PAPP-A)水平,以明确其与冠脉综合征(AS)不稳定斑块的相关关系,探讨PAPP-A在急性冠脉综合征(ACS)中的可能机制。方法使用酶联免疫吸附法(ELISA)分别测定40例急性心肌梗死(AMI)、37例不稳定型心绞痛(UAP)、38例稳定型心绞痛(SAP)及33名非冠心病对照组血中PAPP-A、游离的及总的IGF-I水平。结果血PAPP-A水平在ACS患者明显高于SAP及对照组(P<0.01);与游离的IGF-I存在明显的正相关(P<0.01),而与CK-MB、cTnI无明显相关性(P>0.05)。结论血PAPP-A水平升高与AS斑块的不稳定性有关,提示可作为识别ACS的早期血清学标志物,且其水平的升高与心肌坏死无关。

The clinical significance of Pregnancy associated plasma protein-A in acute coronary syndrome

Objective The study measured serum PAPP-A in different patients with and without coronary disease to explore its relation with atherosclerotic instable plaques and the possible mechanism in ACS. Methods We measured circulating levels of PAPP-A,free IGF-I and total IGF-I in 40 patients with acute myocardial infarction, 37 with unstable angina?38 with stable angina and 33 with controls without atherosclerosis by ELISA. Results Ciculating PAPP-A levels were significantly higher in patients with ACS than in patients with stable angina and controls(P<0.01); and it was significantly and positivly associated with free IGF-I (P<0.01), but no correlation with CK-MB and cTnI levels was observed(P>0.05). Conclution The higher PAPP-A levels is associated with instable plaque which can be looked as a new candidate marker for the early diagnosis of acute coronary syndromes, and it not produced in response to myccardial necrosis.