妊娠相关血浆蛋白A对经皮冠状动脉介入治疗后心肌损伤预测价值

The predictive value of pregnancy associated plasma protein A level for myocardial injury after elective percutaneous coronary intervention

目的:探讨经皮冠状动脉介入治疗术(PCI)前血浆妊娠相关血浆蛋白A(PAPP-A)含量对术后心肌损伤的预测价值。方法:95例择期行PCI的不稳定型心绞痛患者,根据手术前24 h PAPP-A是否升高分为高PAPP-A组(30例,PAPP-A≥10 mU/L)和低PAPP组(65例,PAPP-A<10 mU/L)。检测术前高敏C反应蛋白(hs-CRP)水平及术后24 h内肌钙蛋白I(cTnI)阳性率,并进行2组间各观察指标的比较。结果:高PAPP-A组术前PAPP-A及hs-CRP水平,冠状动脉介入治疗后cTnI阳性率均明显高于低PAPP-A组,差异有统计学意义(P<0.05)。多变量逐步Logistic回归分析表明,PCI前血浆PAPP-A及hs-CRP水平是术后cTnI阳性的独立预测指标(P<0.05)。结论:PCI前血PAPP-A含量是术后心肌损伤的独立预测因素。

Objective： To clarify the predictive value of pre-procedural pregnancy associated plasma protein A level of myocardial injury after percutaneous coronary intervention （PCI）. Method： According to whether PAPP-A ≥10 mIU/L or not, patients were divided into high PAPP-A group and low PAPP-Agroup before PCI. The serum high sensitivity C reactive protein （hs-CRP）levels were detected before PCI. The serum troponin I（cTnI） were measured within 24 hours after PCI, and the comparisons between the two groups were analyzed. Result：the levels of hs-CRP and the rate of positive cTnI in high PAPP-A group were significantly increased compared with low PAPP-Agroup （[2.56±0.13] mg/L： [0.54±0.08] mg/L, P〈0.05）,（81.25 % ： 26.56 %,P〈0.05）. By Logistic regression analysis, independent predictors of positive cTnI after PCI were PAPP-A level and hs-CRP level （all P〈0.05） before PCI. Conclusion： The PAPP-A level before PCI is an independent predictor of postprocedural myocardial injury.