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

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

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。

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 PAPPA 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