摘要
目的探讨妊娠相关血浆蛋白-A(PAPP—A)对急性冠脉综合征(ACS)患者的诊断价值。方法选择49例经冠状动脉造影证实的心肌肌钙蛋白I(cTnI)阴性的冠心病患者,其中ACS患者31例(ACS组),稳定型心绞痛(SAP)患者18例(SAP组),另选择28例冠状动脉造影正常者作为对照组。采用酶联免疫吸附法检测各组血清PAPP-A和超敏C反应蛋白(hs-CRP)水平。结果(1)ACS组PAPP-A和hs-CRP水平较SAP组、对照组均显著增高(P〈0.05)。(2)以PAPP-A 2.79μg/L作为ACS的阳性诊断标准,其灵敏度为81.0%,特异度为84.6%。ROC曲线下面积为0.9,95%可信区间为0.82~0.99。(3)ACS组hs—CRP水平与PAPP-A水平呈正相关(r=0.418,P〈0.01)。结论PAPP-A可作为诊断ACS的指标之一,对于cTnI阴性的ACS患者尤其有价值。
Objective To investigate the diagnostic value of pregnancy-associated plasma protein-A (PAPP-A) in acute coronary syndrome (ACS) patients. Methods Forty-nine cTnI-negative patients with coronary artery disease who were documented by angiography [31 cases with ACS, 18 cases with stable angina (SAP)], and 28 healthy persons were selected as controls. PAPP-A and hs-CRP were analysed with enzyme-linked immunosorbent assay (ELISA). Results Circulating PAPP-A and hs-CRP levels were significantly higher in patients with ACS than those in patients with SAP and controls (P 〈 0.05). PAPP-A threshold value of 2.79 μg/ml identified patients who had ACS with a sensitivity of 81.0% and a specificity of 84.6%. PAPP-A levels were correlated with hs-CRP levels in patients with ACS (r = 0.418, P 〈 0.01 ). Conclusion PAPP-A is a strong candidate marker of ACS, especially to cTnl-negative patients.
出处
《中国医师进修杂志(内科版)》
2009年第3期20-22,共3页
Chinese Journal of Postgraduates of Medicine