急性冠状动脉综合征患者妊娠相关蛋白A与脂联素相关性研究

A correlation study of pregnancy-associated plasma protein and adiponectin in patients with acute coronary syndrome

目的 探讨急性冠状动脉综合征患者血清妊娠相关蛋白A、脂联素、C反应蛋白水平及其相关性,为识别不稳定斑块提供血清学指标. 方法 对61例急性冠状动脉综合征患者（22例急性心肌梗死、19例不稳定型心绞痛、20例稳定型心绞痛）及22例非冠心病患者（对照组）进行血清妊娠相关蛋白A、脂联素、C反应蛋白水平测定分析. 结果 血清妊娠相关蛋白A测定,对照组和稳定性心绞痛组均显著低于不稳定型心绞痛组和急性心肌梗死组（P＜0.01）;脂联素水平测定从高到低依次为对照组＞稳定性心绞痛组＞不稳定型心绞痛组＞急性心肌梗死组,差异均有极显著性（P＜0.01）;C反应蛋白水平测定从高到低依次为不稳定型心绞痛组＞急性心肌梗死组＞稳定性心绞痛组＞对照组,差异均有极显著性（P＜0.01）.妊娠相关蛋白A与C反应蛋白水平呈显著正相关（R=0.668,P＜0.01）,与脂联素呈显著负相关（R=-0.589,P＜0.01）;脂联素与与C反应蛋白水平呈显著负相关（R=-0.855,P＜0.01）. 结论 急性冠状动脉综合征患者血清妊娠相关蛋白A水平明显升高,且与斑块不稳定性相关;妊娠相关蛋白A与脂联素可能共同作用于急性冠状动脉综合征的发生过程.

Objective To explore the levels of pregnancy-associated plasma protein-A （PAPP-A）, adiponectin and C-reactive protein （CRP） and their correlation in patients with acute coronary syndrome （ACS） in order to provide serological index for recognize unstable plaque. Methods Levels of （PAPP-A）, adiponectin and CRP were determined and analyzed in 61 ACS patients [22 acute myocardial infarction （AMI）, 19 unstable angina pectoris （UAP）, 20 stable angina pectoris （SAP）]and 22 non-coronary heart disease ones （control group）. Results Serum PAPP-A levels of both the control and SAP groups were significantly lower than those of both UAP and AMI groups （P〈0. 01）; adiponectin levels were in turn the control 〉 SAP 〉 UAP 〉 AMI group, differences were very significant （P〈0.01） ; CRP levels were in turn the UAP 〉 AMI 〉 SAP 〉 control group, differences were very significant （P〈0. 01）. The PAPP-A was positively related to the CRP levels （R= 0. 668, P〈0. 01） and negatively to adiponectin （R=-0. 589, P〈0.01） ; adiponectin was negatively related to CRP levels （R=-0. 855, P〈0.05）. Conclusion Serum PAPP-A levels of ACS patients significantly heighten and are related to plaque unstability; PAPP-A and adiponectin can play a common role in the development of acute coronary syndrome.