PAPP-A水平及IVS6+95多态性在预测PCI术后再狭窄的价值

The Value of Pregnancy Associated Plasma Protein A and IVS6+95 Gene Polymorphism in Prediction of Restenosis after Percutaneous Coronary Intervention

对超敏C反应蛋白(hs-CRP)、妊娠相关蛋白A(PAPP-A)及IVS6+95(C/G)基因多态性预测不稳定型心绞痛(UAP)患者经皮冠状动脉成形术(PCI)术后再狭窄的意义进行探讨。UAP患者行PCI术(TIMI血流达到3级),3个月～9个月复查冠脉造影,选取血管腔内径狭窄≥75%者(再狭窄组)86例、无再狭窄组(对照组)152例,测定术前术后24hPAPP-A、hs-CRP水平。采用基因测序法分析IVS6+95多态性。再狭窄组术后血清PAPP-A、hs-CRP水平较本组术前明显增高(P<0.001)。对照组术后血清PAPP-A、hs-CRP水平较本组术前明显下降(P<0.001)。再狭窄组IVS6+95中CC基因频率明显高于未发生组(P<0.05),而等位基因C频率无明显差异。PCI术后PAPP-A、hs-CRP血清水平可作为预测冠脉再狭窄的指标,IVS6+95(C/G)多态性可能与术后再狭窄有关,其中基因型CC是致病的基础。

Abstract：To explore the value of pregnancy associated plasma protein A, high sensitivity C--reactive protein and IVS6 ＋ 95 gene polymorphism in prediction of restenosis after percutaneous coronary intervention. The patients with unstable angina pectoris were performed PC1. Those patients were classified as group A （86 cases with related coronary artery lumen loss more than 75% in diameter 3-9months after PCI） and group B（the rest 152 cases with related coronary lumen loss less than 75%）. Serum PAPP-A and hs-CRP levels were examined before and 24h after coronary angiography. The gene polymorphisms was analyzed by gene sequencing. Serum PAPP-A and hs-CRP levels were significantly increased In group A and decreased in group B after PCI （P〈0. 001）. The CC gene frequency of PAPP-A gene IVS6＋95 was signifi- cantly higher in group A than in group B （P〈0.05）. But there were no difference in the frequency of allele C between two groups （P〉0.05）. PAPP- A and hs- CRP level increase after PCI have a strong power in prediction of coronary artery restenosis after PCI. The polymorphism of PAPP-A gene IVS6＋95（C/G） may be associated with postoperative resteno- sis and CC genotypes may he the foundation of pathogen.