冠心病患者妊娠相关血浆蛋白-A的水平及临床意义

Levels of pregnancy-associated plasma protein-A in patients with coronary heart diseases and clinic significance

目的:探讨妊娠相关血浆蛋白-A(PAPP-A)与冠心病发生、发展及血脂之间的关系。方法:冠心病组患者75例,包括急性心肌梗塞患者(AMI)32例、不稳定心绞痛(UAP)患者22例、稳定性心绞痛(SAP)患者21例及正常对照组60例。采用双抗体夹心酶联免疫吸附实验检测PAPP-A,采用双抗体放射免疫法检测IL-6,采用ABC-HRP方法测定IL-10,采用全自动生化分析仪测定血脂。结果:①PAPP-A在急性冠脉综合征(ACS,包括急性心肌梗塞、不稳定心绞痛)患者中浓度较稳定性心绞痛和正常对照组明显偏高(P<0.05)。②PAPP-A与血清总胆固醇(TC)、ApoA1/ApoB的浓度有明显相关性(r=0.348、-0.420,P<0.05)。③IL-6、IL-10浓度冠心病患者较正常对照明显偏高(P<0.05);且在AMI、UAP、SAP组组间比较差异均有显著性(P<0.05);PAPP-A与IL-6、IL-10呈正相关(Spearman相关系数分别为0.446、0.523,P<0.05)。结论:PAPP-A与冠心病发生、发展关系密切,可作为冠心病粥样斑块不稳定性的重要标志。

Objective To explore the relationship between pregnancy-associated plasma protein-A （PAPP-A） and occurance, development of cardiovascular diseases, and lipids. Methods 75 patients with coronary disease were divided into acute myocardial infarction （n= 32）, unstable angina pectoris （n=22） and stable angina pectoris （n= 21） groups, and 60 subjects without coronary diseases were used as controls. The serum PAPP-A, IL-6, IL-10, lipids were measured in all patients and controls by different methods of enzymatically amplified two-step sandwith- type immunoassay, double antibody radio-immunoassay, ABC-HRP, auto biochemistic analytist. Results ①The level of PAPP-A in acute coronary syndrome （ACS, including acute myocardial infarction and unstable angina pectoris） patients was significantly higher than that in stable angina pectoris patients and controls （P〈0. 05）. ②There were significantly associations between PAPP-A and serum totle cholesterol, ApoA1/ApoB （r= 0. 348, 0. 420, P〈0. 05）. ③The levels of IL-6 and IL-10 in coronary heart disease patients were significantly higher than those in controls （P〈0. 05）, and the variations among acute myocardial infarction, unstable angina pectoris, stable angina pectoris patients were significantly （P 〈 0. 05）. There were significantly associations between PAPP-A, IL-6 and IL-10 （Spearman r 0. 446, 0. 523, P〈0. 05）. Conclusion PAPP-A is significantly associated with occurance and development of coronary heart disease , probablely as a marker of unstable plaque in coronary heart disease .