辛伐他汀对不稳定型心绞痛患者血清PAPP-A水平变化的影响

The effect of simvastatin on the levels of pegnancy-associated plasma protein-A in patients with unstable angina pectoris

目的 探讨不稳定型心绞痛（UA）患者血清妊娠相关血浆蛋白-A（PAPP-A）水平变化及辛伐他汀对其的影响.方法 将40例UA患者随机分为常规治疗组20例,辛伐他汀治疗组20例,观察两组患者治疗8周前、后血清PAPP-A水平的变化.血清PAPP-A测定采用酶联免疫吸附法.结果 ①两组患者的年龄、性别、吸烟史、血压、血糖、血脂水平等差异无统计学意义（P＞0.05）.②治疗前两组患者血清PAPP-A水平差异无统计学意义[（20.92±5.70）mU/L比 （20.68±5.94）mU/L,P＞0.05].③治疗8周后常规治疗组与辛伐他汀治疗组患者血清PAPP-A水平较治疗前明显降低,两组间比较差异有统计学意义[（16.98±5.94）mU/L 比 （13.53±4.964）mU/L,P＜0.05].结论 ① UA患者血清PAPP-A水平升高,表明UA患者存在易损斑块.作为易损斑块的血清学标志物,PAPP-A水平可能在UA的早期诊断和预测中有重要的临床意义.②UA患者的常规治疗在一定程度上可以提高动脉斑块的稳定性,加用辛伐他汀后可进一步稳定动脉斑块.

Objective To discuss the effect of simvastatin on the serum levels of pegnancy-associated plasma protein-A in patients with unstable angina pectoris. Methods 40 patients with unstable angina pectoris were randomly divided into conventional therapeutic group （rt=20） and simvastatin therapeutic group （n=20）. The serum levels of pegnancy-associated plasma protein-A were assayed before and 8 weeks after treatment in two groups. PAPP-A levels was measured by enzyme-linked immunosorbent as-say （ELISA）. Results （1）There were no significant difference between the two groupsin age, sex, the smoking history, blood pressure, blood glucose and blood cholesterol levels （P〉0.05）. （2）Before the treatment, there was no significant difference between the two group in the levels of serum PAPP-A[ （20.92±5.70）mU/L vs （20.68±5.94）mU/L, P〉0.051. （3）After 8 weeks of treatment, there was obvious decrease in the levels of serum PAPP-A between the two groups. The difference of two groups was significant [（16.98±5.94）mU/L vs （13.53±4.96）mU/L, P〈0.05]. Conclusion （1）The levels of serum PAPP-A increase in unstabie angina pectoris, which indicate that there are vulnerable plaque in the unsta- ble angina pectoris patients. The levels of serum PAPP-A as biomarker of vulnerable plaque are likely to have important clinic significance in diagnosis and forecast the unstable angina pectoris. （2）General medical treatment can increase stability of arterial plaque in a certain extent, adding simvastatin can stabilize plaque more and decrease cardiovascular events.