不稳定型心绞痛患者妊娠相关血浆蛋白A与高敏C反应蛋白的相关性  

The Relationship between Pregnancy-Associated Plasma Protein A and High-Sensitivity C-Reactive Protein in Patients with Unstable Angina

作　　者：梅卫义[1] 杜志民[1] 胡承恒[1] 张辉[2] 李怡[1] 罗初凡[1] 陈国伟[1] 

机构地区：[1]中山大学附属第一医院心内科,广东省广州市510080 [2]中山大学附属第三医院心内科,广东省广州市510360

出　　处：《中国动脉硬化杂志》2005年第2期207-209,共3页Chinese Journal of Arteriosclerosis

摘　　要：目的　探讨不稳定型心绞痛患者妊娠相关血浆蛋白A水平与高敏C反应蛋白的关系及其与动脉粥样硬化斑块稳定性的关系。方法　不稳定型心绞痛组与稳定型心绞痛组患者,行冠状动脉造影前采用酶联免疫法检测妊娠相关血浆蛋白A水平,并检测高敏C反应蛋白及其他血清学指标,对造影结果进行Jenkins评分。结果　不稳定型心绞痛组与稳定型心绞痛组之间相比,高敏C反应蛋白和妊娠相关血浆蛋白A水平的差异均有显著性(P<0 .0 0 1) ;两组Jenkins评分差异有显著性(P <0 .0 0 1)。妊娠相关血浆蛋白A水平与高敏C反应蛋白呈正相关(r=0 .4 4 ) ;多因素回归分析显示妊娠相关血浆蛋白A水平与高敏C反应蛋白正相关和肌钙蛋白I存在直线关系,Jenk ins评分与妊娠相关血浆蛋白A水平、肌钙蛋白I及高密度脂蛋白存在直线关系。结论　妊娠相关血浆蛋白A水平可作为临床评估冠心病患者病情稳定程度,并进而可能成为评价冠状动脉斑块稳定性的指标之一。Aim To investigate the relationship between the levels of pregnancy-associated plasma protein-A (PAPP-A) and high-sensitivity C-reactive protein (hs-CRP) in patients with unstable angina (UA), and the role of PAPP-A in predicting the stability of atherosclerotic plaques. Methods Patients were divided into two groups according to the clinic presentation, one with stable angina pectoris (SA group, n=38) and one with UA (UA group, n=42). The levels of PAPP-A, hs-CRP and other serum biomarkers were measured before coronary angiography; the angiograms were analyzed with Jenkins score. Results The plasma hs-CRP, PAPP-A levels in patients with UA increased significantly, compared with those in SA group (hs-CRP 4.40±0.003 vs 0.48±0.016 mg/L, P<0.001; PAPP-A 18.40±0.002 vs 7.79±0.001 mIU/L, P<0.001); the Jenkins scores of coronary artery angiography in patients with UA increased significantly compared with those in SA group (5.06±0.002 vs 1.94±0.002,P<0.001). PAPP-A was significantly related with hs-CRP (r=0.44); using the method of Multiple Regression and Correlation, PAPP-A had linear relationship with hs-CRP, cardiac troponin I (cTnI) in all of the cases, and Jenkins scores had linear relation with PAPP-A, cTnI and high density lipoprotein cholesterol. Conclusions PAPP-A can play a role in evaluating the clinic stability of the patients with coronary artery disease, and may act as one of the biomarkers of vulnerable plaques.

关 键 词：内科学 不稳定型心绞痛 酶联免疫法 妊娠相关血浆蛋白A 高敏C反应蛋白 冠状动脉造影 斑块稳定性 

分 类 号：R541.4[医药卫生—心血管疾病]