急性冠脉综合征患者发病与妊娠相关血浆蛋白A的相关性分析

Correlation between pathogenesis of acute coronary syndrome and pregnancy-related plasma protein A level

目的探讨妊娠相关血浆蛋白A与急性冠脉综合征患者发病的相关性。方法选择2013年2月—2014年5月期间于哈尔滨医科大学附属第二医院就诊的60例临床诊断为急性冠脉综合征(ACS)的患者为研究对象,其中变异性心绞痛(UAP)患者28例,急性心肌梗死(AMI)患者32例,另外选稳定型心绞痛(SAP)患者30例作为SAP组,30例作为健康对照组。记录所选对象的性别、年龄及其生命体征等一般资料,并于入院第1天取空腹静脉血行NTT、血常规、血尿酸、CK-MB、超敏C反应蛋白(hs-CRP)、血脂等检查,并收集血标本行妊娠相关血浆蛋白A(PAPP-A)检测,比较各组间各项指标检测水平的差异,并评价妊娠相关血浆蛋白A与超敏C反应蛋白水平之间的相关性。结果各组患者在年龄、性别、BMI等指标之间的差异无统计学意义;PAPP-A在急性冠脉综合症组与健康对照组之间的差异具有统计学意义(P<0.01);对比各组患者的各项血清学指标,结果显示总体差异均具有统计学意义(P<0.05),各组与对照组相比差异也有统计学意义;且PAPP-A与hs-CRP之间的相关性具有统计学意义(r=0.978,P<0.001)。结论急性冠脉综合征患者发病与妊娠相关血浆蛋白之间具有正相关性,PAPP-A的浓度越高,发生急性冠脉综合征的危险性越大。

Objective To investigate the correlation between pregnancy-related plasma protein A level and the pathogenesis of acute coronary syndrome（ ACS）. Methods Sixty patients with ACS in our hospital from February,2013 to May,2014 were enrolled in this study. Among them,28 cases were with variant angina（ UAP）,32 patients with acute myocardial infarction（ AMI）. Another 30 patients with stable angina pectoris（ SAP） were selected as the SAP group and 30 healthy individuals as the healthy control group. The general information on the sex,age and vital signs of selected cases were recorded. On the first day after admission,fasting venous blood was collected for NTT,blood test,serum uric acid,CK-MB,hs-CRP,blood lipids and other tests. Blood samples were collected for pregnancy-related plasma protein A（ PAPP-A） test. The differences of the levels of each index in each group were compared,and the correlation between pregnancy-related plasma protein A and high-sensitivity C-reactive protein was evaluated. Results There were no significant difference in the age,gender,BMI and other indicators between the three groups. PAPP-A was significantly different between those acute coronary syndrome groups and healthy control group（ P〈0. 01）. The serological indexes of each group were compared,the results showed that the overall differences were statistically significant（ P〈 0. 05）,and there was significant difference between each group and the control group; and the correlation between PAPP-A and hs-CRP Sex was statistically significant（ r = 0. 978,P 〈0. 001）. Conclusion The incidence of ACS and pregnancy-related plasma protein A has a positive correlation,the higher the concentration of PAPP-A,the greater the risk of acute coronary syndrome.