妊娠相关蛋白酶-A、C-反应蛋白、丙二醛化低密度脂蛋白的变化与急性冠脉综合征相关性研究  

Relation of pregnancy-associated plasma protein-A, C-reactive and malondialdehyde- modified low density lipoprotein to acute coronary syndrome

作　　者：李旭平[1] 张志辉[1] 周胜华[1] 刘启明[1] 方臻飞[1] 祁述善[1] 

机构地区：[1]中南大学湘雅二医院心内科,湖南长沙410011

出　　处：《中国现代医学杂志》2005年第1期86-88,91,共4页China Journal of Modern Medicine

基　　金：湖南省自然科学基金课题(NO:02JJY2043)

摘　　要：目的观察妊娠相关蛋白酶-A(PAPP-A)、C-反应蛋白(CRP)及丙二醛化低密度脂蛋白(MDA-LDL)在急性冠脉综合征中的变化及其相关性。方法68例经冠状动脉造影证实的冠心病患者,其中急性冠脉综合征43例,稳定性心绞痛25例,另选20例正常健康人为对照组,采用酶联免疫吸附法(ELISA)检测血浆PAPP-A水平;采用超敏免疫透射比浊法测血浆CRP;采用硫代巴比妥酸(TBA)法测定血浆MDA-LDL水平。结果ACS组PAPP-A、CRP和MDA-LDL均明显高于对照组[PAPP-A:(17.9±8.7)mIu/L VS(7.1±4.2)mIu/L,P <0.01;CRP:(4.31±0.38)mg/L VS (2.01±0.14)mg/L,P <0.01;MDA-LDL:(0.94±0.26)mmol/L VS (0.51±0.22)mmol/L,P <0.01];ACS组PAPP-A、CRP和MDA-LDL显著高于稳定性心绞痛组(PAPP-A:(17.9±8.7)mIu/L VS (8.5±5.6)mIu/L,P <0.01;CRP:(4.31±0.38)mg/L VS (2.13±0.28)mg/L,P <0.05;MDA-LDL:(0.94±0.26)mmol/L VS (0.54±0.23)mmol/L,P <0.05);每增加PAPP-A 5 mI-u/L,CRP 1 mg/L,MDA-LDL 0.2 mmol/L,急性冠脉综合征发生危险性分别增加1.9,1.6,1.4倍。结论急性冠脉综合征患者PAPP-A,C-反应蛋白及MDA-LDL升高且均与ACS存在显著相关性,可能是ACS发生的危险因素。To observe the relation of pregnancy-associated plasma protein-A (PAPP-A), C-reactive protein (CRP) and malondialdehyde-modified low density lipoprotein (MDA-LDL) with acute coronary syndrome (ACS) patients. Sixty-eight patients with coronary artery disease who were documented by angiography, 43 cases with acute coronary syndrome, 25 cases with stable angina (SAP), 20 nomal control. All of them were measured serum CRP by using untrasensitive immunosorbent assay (ELISA) and MDA-LDL by using thibaturic acid (TBA). PAPP-A, CRP and MDA-LDL were significantly higher in ACS group compared with control [PAPP-A: (17.9±8.7) mIu/L VS (7.1±4.2) mIu/L, P<0.01; CRP: (4.31±0.38) mg/L VS (2.01±0.14) mg/L, P <0.01; MDA-LDL: (0.94±0.26) mmol/L VS (0.51±0.22) mmol/L, P <0.01] PAPP-A, CRP and MDA-LDL were significantly elevated in ACS patients than in stable angina patients [PAPP-A: (17.9±8.7) mIu/L VS (8.5±5.6) mIu/L, P <0.01; CRP: (4.31±0.38) mg/L VS (2.13±0.28) mg/L, P<0.05; MDA-LDL: (0.94±0.26) mmol/L VS (0.54±0.23) mmol/L, P <0.05]. By logistic regression, the odds ratio (OR) of PAPP-A, CRP and MDA-LDL was>1, which means they were risk factors. [Conclusion] The serum PAPP-A, CR and MDA-LDL are increased in ACS. These results suggest that PAPP-A, CRP and MDA-LDL have a strong association with ACS and are risk factors of ACS.

关 键 词：急性冠脉综合征 C-反应蛋白 妊娠相关蛋白酶-A 丙二醛化低密度脂蛋白 

分 类 号：R543.3[医药卫生—心血管疾病]