妊娠相关血浆蛋白A与血清新蝶呤在不稳定型心绞痛病变中的意义

Clinical implications of increased pregnancy-associated plasma protein-A and neopterin in patients with unstable angina

目的探讨冠心病患者血清妊娠相关血浆蛋白A(PAPP-A)、血清新蝶呤(NPT)水平与冠状动脉不稳定斑块的相关性。方法应用ELISA方法检测正常对照(C组,31例)、稳定型心绞痛(SA组,41例)、不稳定型心绞痛(UA组,61例)患者血清PAPP-A、NPT水平。冠状动脉造影检测冠脉复杂狭窄数量。结果 UA组血清PAPP-A、NPT水平分别为(12.17±3.08)μg/L、(9.27±3.01)μg/L,明显高于SA组的(8.38±3.31)μg/L、(7.16±3.60)μg/L和对照组的(4.71±3.09)μg/L、(5.01±1.70)μg/L(P<0.01);UA组血清PAPP-A水平和NPT呈显著正相关(r=0.45,P<0.01);在SA组和C组血清PAPP-A水平和NPT无明显相关性(P>0.05)。UA组冠脉复杂狭窄数明显大于SA组和C组(P<0.01);UA组血清PAPP-A、NPT水平均与冠脉复杂狭窄数呈正相关(r1=0.51,r2=0.36,P<0.01)。结论冠心病患者血清PAPP-A与NPT水平升高提示冠脉斑块不稳定,可能是冠脉病变活动性的指标。

Objective To investigate whether serum pregnancy-associated plasma protein-A（PAPP-A） and neopterin（NPT） levels are related to angiographic morphology of coronary lesions in patients with unstable angina（UA）.Methods A total of 102 patients with coronary arterial disease（CAD） was assigned to group UA（with unstable angina,61 cases） and group SA（with stable angina,41 cases）.Another 31 normal people were taken as group C.Serum PAPP-A and NPT were measured by ELISA.The complex coronary stenosis numbers were measured by coronary angiography.ResultsSerum PAPP-A and NPT were（12.17±3.08） μg/L and（9.27 ±3.01） μg/L in group UA,which were all significantly higher than（8.38±3.31） μg/L and（7.16±3.60） μg/L in group SA and（4.71±3.09） μg/L and（5.01±1.70） μg/L in group C（P0.01）.Serum PAPP-A level was positively correlated to NPT in group UA（r=0.45,P0.01）.There was no any significant correlation between PAPP-A and NPT level in groups of SA and C（P0.05）.The complex coronary stenosis numbers in group UA were significantly greater than those in groups of SA and C（P0.01）.Serum PAPP-A and NPT levels were all positively correlated with complex coronary stenosis numbers in group UA（r1=0.51,r2=0.36,P0.01）.Conclusion The increases of serum PAPP-A and NPT levels indicate the unstability of coronary artery plaque,which may be the markers for the activity of coronary artery disease.