血清妊娠相关血浆蛋白-A与急性冠状动脉综合征的临床相关性

The clinical relevance between the serum level of pregnancy-associated plasma protein-A and the degree of acute coronary syndrome

目的 :探讨血清妊娠相关血浆蛋白 A(PAPP A)与急性冠状动脉综合征 (ACS)的关系。方法 :经冠状动脉造影 (CAG)确诊的冠心病患者 6 1例 ,其中ACS患者 4 6例 ,包括急性心肌梗死 (AMI) 16例 ,不稳定型心绞痛 (UAP) 30例 ;稳定型心绞痛 (SAP) 15例 ;另设CAG排除冠心病患者 2 4例作为正常对照组。运用酶联免疫吸附法测定各组血清PAPP A浓度。结果 :ACS患者组、SAP组、正常对照组血清PAPP A浓度分别为 (2 1.10±6 .95 )、(15 .2 1± 3.87)、(15 .5 0± 3.18)mIU/L ;此外 ,ACS组内AMI和UAP者血清PAPP A浓度分别为 (2 4 .79± 7.88)、(19.13± 5 .6 0 )mIU/L。SAP组与AMI及UAP者之间PAPP A浓度差异有统计学意义 (P <0 .0 1和P<0 .0 5 ) ,SAP组与正常对照组之间差异无统计学意义 (P >0 .0 5 ) ;AMI与UAP者之间差异有统计学意义 (P<0 .0 5 )。血清PAPP A水平与C反应蛋白、白细胞之间呈明显的正相关。与总胆固醇、三酰甘油、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、血小板计数之间无明显相关性。结论 :ACS患者血清PAPP A浓度明显升高 ,与冠状动脉斑块的稳定性密切相关 ,提示其有助于冠心病的危险分型 。

Objective:To investigate the relevance between pregnancy-associated plasma protein-A (PAPP-A) and the acute coronary syndrome(ACS).Method:There are 61 coronary heart diseases(CHD) patients diagnosised by CAG including 46 ACS patients,15 SAP patients,24 non-CAD patient excluded by CAG as the control group. Forty-six ACS patients are separated into 16 AMI and 30 UAP patients.The serum level of PAPP-A is detected by ELISA.Result:There are remarkable statistics difference between AMI and SAP group(P< 0.01),AMI and UAP group(P< 0.05), UAP and control group(P< 0.05), but there is no remarkable statistics difference between SAP group and control group(P> 0.05). There is obvious correlation between the level of serum PAPP-A and the level of CRP and the number of WBC,but there is no obvious correlation between the level of serum PAPP-A and the number of plateletand the level of TC, TG, HDL-C, LDL-C.Conclusion:The concentration of PAPP-A in ACS patients is higher obviously and related to the stability of the plaque in coronary artery. which suggest the serum level of PAPP-A contribute to type the CHD, and could be one of the monitoring marker for CHD in clinic practices.