慢性稳定性心绞痛患者妊娠相关蛋白-A水平及其与冠状动脉病变程度的相关性

Relationship Between Pregnancy Associated Plasma Protein-A and the Severity of Coronary Artery Disease Extent in Patients With Chronic Stable Angina Pectoris

目的:探讨慢性稳定性心绞痛(CSA)患者妊娠相关蛋白-A(PAPP-A)的水平,及其与心血管危险因素和冠状动脉(冠脉)病变复杂程度的相关性。方法:入选因慢性胸痛接受诊断性冠脉造影的146例患者,平均年龄(57.1±8.2)岁,男性105例(71.9%),女性41例(28.1%)。146例患者中,冠脉正常或狭窄<50%者38例,为非CSA组;冠脉狭窄≥50%者108例,为CSA组,其中单支病变46例,多支病变62例。分析患者PAPP-A水平及其与心血管危险因素、左心室射血分数和冠脉SYNTAX评分的相关性。结果:PAPP-A水平(mIU/L):CSA组高于非CSA组(6.3±3.6 vs 3.7±1.0,P<0.001),多支冠脉病变者高于单支病变者(6.9±4.5 vs 5.4±1.5,P=0.011),男性明显高于女性(5.9±3.5 vs 4.4±2.7,P=0.021),高血压患者明显高于血压正常者(6.5±3.8 vs 4.4±2.4,P<0.001),差异均有统计学意义。CSA患者PAPP-A水平与冠脉SYNTAX评分成正相关(r=0.374,P<0.001),高敏C反应蛋白水平与冠脉SYNTAX评分无关(r=0.141,P=0.144)。单因素及多因素回归分析显示,PAPP-A水平与年龄(r=0.225,P=0.006)、冠脉SYNTAX评分呈正相关(r=0.374,P<0.001)。年龄和PAPP-A水平是CSA的独立危险因素。结论:PAPP-A水平与男性、年龄、高血压、冠脉病变范围及程度有关,PAPP-A是CSA的独立危险因素。

Objective： To assess the relationship between pregnancy associated plasma protein-A（PAPP-A） and other cardiovascular risk factors with the severity of coronary artery disease（CAD） extent in patients with chronic stable angina（CSA）.Methods： A total of 146 patients with chest pain at the mean age of（57.1±8.2）years undergoing diagnostic coronary angiography were studied,there were 105（71.9%） male and 41（28.1%）female.The patients were divided into two groups,Non-CSA group,n=38,the patients＇ coronary artery stenosis50%,and CSA group,n=108,the patients＇ coronary artery stenosis50%,among them,46 with single vessel disease and 62 with multi-vessel disease.PAPP-A level,cardiovascular risk factors,left ventricular ejection fraction（LVEF） and coronary SYNTAX score were analyzed in both groups.Results： PAPP-A level（mIU/L） was higher in CSA group than that in Non-CAS group（6.3±3.6 vs.3.7±1.0,P0.001）,was higher in patients with multi-vessel disease than single vessel disease（6.9±4.5 vs.5.4±1.5,P=0.011）,higher in male than female（5.9±3.5 vs.4.4±2.7,P=0.021）,higher in patients with hypertension than those without hypertension（6.5±3.8 vs.4.4±2.4,P0.001）.PAPP-A positively correlated with the age（r=0.225,P=0.006） and coronary SYNTAX score（r=0.374,P0.001）.Age and increased PAPP-A level were the independent risk factors of CSA.Conclusion： PAPP-A level was correlated with male gender,age,hypertension and the severity of CAD extent.PAPP-A was an independent risk factor of CSA.