急性脑梗死患者血清PAPP-A水平与颈动脉粥样硬化斑块的相关性  

Relationship of Serum Levels of Pregnancy-associated Plasma Protein-A with Carotid Atherosclerotic Plaque in Acute Cerebral Infarction

作　　者：王本孝[1,2] 王俊珺[1,2] 赵学敏[1,2] 秦淑国[1,3] 方开峰[1,4] 王鹏[1,2] 

机构地区：[1]皖北煤电集团总医院 [2]蚌埠医学院第三附属医院神经内科,安徽省宿州市234011 [3]蚌埠医学院第三附属医院检验科,安徽省宿州市234011 [4]蚌埠医学院第三附属医院超声科,安徽省宿州市234011

出　　处：《中国动脉硬化杂志》2015年第2期156-160,共5页Chinese Journal of Arteriosclerosis

基　　金：安徽省淮北市科技局科技人才培育基金项目(20110315)

摘　　要：目的探讨急性脑梗死患者妊娠相关血浆蛋白A(PAPP-A)水平与颈动脉粥样硬化斑块的关系。方法应用彩色多普勒超声检查79例急性脑梗死组患者和64例正常对照者的颈动脉斑块及内膜中膜厚度(IMT),同时检测血清PAPP-A水平;将急性脑梗死患者依据颈动脉超声检查结果分为颈动脉无斑块组15例,稳定性斑块组20例,不稳定性斑块组44例,比较各组血清PAPP-A水平。结果急性脑梗死斑块检出率、不稳定性斑块检出率及IMT均显著高于正常对照组(P<0.01),血清PAPP-A水平高于正常对照组(P<0.05)。在急性脑梗死患者中,不稳定性斑块组血清PAPP-A水平显著高于稳定性斑块组和无斑块组,稳定性斑块组血清PAPP-A水平显著高于无斑块组(P<0.01)。线性相关分析显示,急性脑梗死组患者IMT与血清PAPP-A水平有明显相关性(r=0.718,P<0.01)。结论颈动脉粥样硬化斑块及其稳定性与脑梗死发生有密切关系;PAPP-A与颈动脉粥样硬化密切相关,可能是不稳定性粥样硬化斑块的血清标志物。Aim To investigate the relationship of serum levels of pregnancy-associated plasma protein-A( PAPP-A) with carotid atherosclerotic plaque in acute cerebral infarction. Methods Carotid artery intima-media thickness( IMT) and the characteristic of atherosclerotic plaque were examined by carotid ultrasonography and the levels of serum PAPP-A were measured by enzyme immunoassay in 79 patients with acute cerebral infarction and 64 normal controls.Patients with acute cerebral infarction were divided into no plaque group( 15 cases),stable plaque group( 20 cases) and unstable plaque group( 44 cases) according to their carotid artery sonography. The serum levels of PAPP-A were compared among different groups. Results The rate of plaque and IMT in acute cerebral infarction group were significantly increased compared with those of the nomal control group( P < 0. 01). The serum levels of PAPP-A in acute cerebral infarction group were significantly higher than those of the nomal control group( P < 0. 05). Among patients with cerebral infarction,the serum levels of PAPP-A in unstable plaque group were significantly increased than those of no plaque group and stable plaque group( P < 0. 01),the later was significantly higher than no plaque group( P < 0. 01). Linear correlation analysis showed that serum levels of PAPP-A was positively correlated with IMT( r = 0. 718,P < 0. 01) in patients with cerebral infarction. Conclusion Carotid atherosclerosis and plaque stability are closely related to the formation of cerebral infarction. The serum levels of PAPP-A was closely related to the carotid atherosclerosis,which may be a potential serum marker of unstable atherosclerotic plaques.

关 键 词：妊娠相关血浆蛋白A 急性脑梗死 颈动脉内膜中膜厚度 动脉粥样硬化斑块 

分 类 号：R743.33[医药卫生—神经病学与精神病学]