急性冠状动脉综合征患者血浆妊娠相关蛋白A、胰岛素样生长因子Ⅰ的变化及临床意义

The clinical significance of pregnaucy associated plasma protein-A,insulin growth factor-Ⅰin acute coronary syndrome patients

目的:探讨急性冠状动脉综合征(ACS)患者血浆中妊娠相关蛋白A(PAPP-A),胰岛素样生长因子Ⅰ(IGF-)的变化及临床意义。方法:对112例经冠状动脉造影证实的冠心病患者(急性冠脉综合征73例,稳定性心绞痛39例),采用酶联免疫吸附法(ELISA)检测血浆PAPP-A、IGF-Ⅰ,并与健康对照组作对照观察。结果:1ACS组血浆中PAPP-A、IGF-浓度均显著高于对照组(P<0.01)和SAP组(P<0.05)。2SAP组与正常对照组之间PAPP-A、IGF-Ⅰ均无显著性差异(P>0.05)。3血PAPP-A水平在ACS患者中与游离的IGF-Ⅰ有明显正相关(P<0.001),而与总的IGF-Ⅰ、CK-MB和CTnT无明显相关性P>0.05)。结论:PAPP-A、IGF-Ⅰ在ACS患者血浆中均显著升高,免疫酶技术可作为ACS患者的早期诊断敏感血清学标志物。

Objective： To invetigate the changes and the clinical significance of pregnaucy associated plasma protein-A （PAPP-A） ,insulin growth factor- Ⅰ （IGF- Ⅰ ） in acute coronary syndrome （ACS） patients . Methods ： 112 patients with coronary artery disease were documented by angiography in this study. 73 cases with ACS, 39 cases with stable angina （SAP）, 20 normal health control, all the patients＇ plasma was analysed for PAPP-A and IGF- Ⅰ with enzyme linked immunosorbent assay （ELISA）. Results：（1） PAPP-A,IGF-Ⅰ were higher in ACS group compared with normal healthy control group（P〈0.01）and SAP group（P〈0.01,0.05）. （2） PAPP-A,IGF- Ⅰ were not significantly changes in SAP group compared with normal healthy control group（P〉 0.05）.（3） PAPP-A leval was positively correlated with free IGF-Ⅰ （P〈0. 01）,but no correlation with total IGF-Ⅰ ,CK-MB and cTnT in ACS group（P〉0.05）. Conclusion： PAPP-A,IGF-Ⅰ are elevated in ACS patients and associated with instable plaque,then PAPP-A can be used as a new candidate marker for the diagnosis of ACS.