血清淀粉样蛋白A与冠心病的相关性研究

Relationship between serum amyloid A and coronary heart disease

目的:探讨血清淀粉样蛋白A(SAA)与冠心病(CHD)发生、病变程度及预后的关系。方法:分析88例CHD和92例对照者临床资料并测定高敏C反应蛋白(hsCRP)和SAA。结果:急性冠状动脉综合征(ACS)患者血清SAA及hsCRP水平高于稳定型心绞痛(SAP)组和对照组(P<0.01),SAA水平与hsCRP水平呈正相关(r=0.807,P<0.01);在Gensini积分位于20～40分及大于40分2组的SAA和hsCRP明显高于Gensini积分小于20分的亚组(P<0.01),但与病变范围无关。以SAA≥4.80mg/L或hsCRP≥3.73mg/L作为异常增高上限,对CHD临床识别的敏感性SAA(80.7%)优于hsCRP(61.4%)。SAA水平增高组血管重建的发生率高于SAA水平正常组,差异有统计学意义(P<0.05)。比较CHD危险因素导致CHD发生的危害性,结果显示:SAA>TC>高血压史>吸烟>年龄。结论:炎症反应贯穿于CHD的发生发展,SAA和hsCRP对冠状动脉病变的严重程度有一定的预测价值。SAA对CHD临床识别的敏感性较高,对于及时发现高危人群具有一定的临床意义,SAA在判断CHD的预后方面可能有一定的临床意义。

Objective：To study the relationship between plasma levels of serum amyloid A protein（SAA） concentrations and clinical course（including prognosis） in patients with CHD.Method：88 patients with CHD and 92 controls were enrolled.The clinical data were obtained,and the plasma concentration of hsCRP and SAA were measured.Result：The concentration of SAA is highly correlated with hs-CRP（r=0.807,P0.01）.We demonstrated that the concentration of SAA and hs-CRP were significantly higher in group of ACS than in group of SAP and control subjects（P0.01）.There is significant difference between the Gensini score of 20-40（or40） and Gensini score 20,but there is no relationship with lesions area.We demonstrated that the incidence of CHD is higher with the concentration of SAA≥4.80 mg/L or hs-CRP ≥3.73 mg/L than lower,and the sensitivity are 80.7%（SAA） and 61.4%（hsCRP）.There is significant difference in prognisis of revascularization between two SAA groups（P0.05）.The relative importance comparison study among risk factors of CHD： SAATCthe history of hypertensionsmokingage.Conclusion：Inflammation is associated with coronary artery disease progression.SAA may have a potential role in predicting the severity of CHD with high sensitivity.SAA may predict the prognosis of CHD in many aspecters.