血清妊娠相关蛋白-A在心力衰竭中的诊断和预后价值

Clinical Value of Pregnancy-Associated Plasma Protein A in Patients with Heart Failure

目的探讨心力衰竭患者血清妊娠相关蛋白A（Pregnancy-Associated Plasma Protein A，PAPP-A）的变化，及其在诊断和预后中的价值。方法选取72例心力衰竭患者和50名体检人员作为研究对象，用ELISA方法测定血清PAPP-A的水平。结果心力衰竭组血清PAPP—A水平（8．8±2．3ng／mL）显著高于正常对照组（4．7±1．9ng／mL），且随心功能分级呈进行性增加。血清PAPP—A水平的ROC曲线下面积为0．7782（0．688—0．876），诊断心力衰竭的灵敏度和特异度分别为86．1％和62．0％。血清高PAPP-A水平的心力衰竭患者的生存率显著低于血清低PAPP-A水平的心力衰竭患者。结论血清PAPP-A的检测在心力衰竭的诊断、评价心力衰竭严重程度及预后中有重要价值。

Objective To assess the value of pregnancy-associated plasma protein A （PAPP-A） level in diagnosis and prognosis in patients with heart failure.Methods A total of 72 patients with heart failure and 50 healthy controls were collected.Serum PAPP-A were measured by ELISA methods.Results The level of serum PAPP-A was higher in patients with heart failure（8.8 ± 2.3ng/mL） than those in healthy controls（4.7±1.9ng/ mL）,and PAPP-A levels might be correlated with the severity of heart failure.The area under receiver operating curves of serum PAPP-A was 0.7782（0.688 -0.876）,the sensitivity and specificity were 86.1% and 62.0%,respectively.Kaplan-Meier analysis demonstrated that the group with high PAPP-A had a significantly higher death rate than the group with low PAPP-A.Conclusion Serum PAPP-A level is helpful for diagnosis of heart failure,and is related to the severity of heart failure,suggesting that PAPP-A might be involved in the pathogenesis of heart failure.