急性冠脉综合征中妊娠相关蛋白-A与斑块不稳定性  

Relationship between PAPP-A and unstable coronary atherosclerotic plaque in patients with acute coronary syndrome

作　　者：石增刚[1] 马礼坤[1] 余华[1] 冯克福[1] 

机构地区：[1]安徽医科大学附属省立医院心内科,合肥230001

出　　处：《安徽医科大学学报》2006年第3期330-332,共3页Acta Universitatis Medicinalis Anhui

基　　金：安徽省优秀青年基金资助(编号:04043054)

摘　　要：目的探讨妊娠相关蛋白-A(PAPP-A)在急性冠脉综合征(ACS)中的变化及其与斑块不稳定性的关系。方法26例冠脉正常者作为对照组,稳定性心绞痛(SA)组22例,ACS组40例,包括不稳定性心绞痛(UA)20例、急性心肌梗死(AMI)20例。定量检测外周血PAPP-A、C-反应蛋白(CRP)、肌酸激酶MB同工酶(CK-MB)。对所有冠脉造影显示狭窄≥30%的病变进行影像学分析。结果ACS中PAPP-A含量(13·19±4·04)mIU/L明显高于SA(5·47±3·00)mIU/L(P<0·01)及对照组(5·09±2·19)mIU/L(P<0·01);并且与CRP(r=0·62P<0·01)、复杂性狭窄的数量(r=0·45P<0·05)有显著的正相关。结论PAPP-A在ACS患者外周血中明显升高,可能与斑块的不稳定性有关,对ACS的危险度分层可能具有一定的价值。Objective To explore the variety of plasma PAPP-A level and the relationship between PAPP-A concentration and the stability of coronary atherosclerotic plaque in patients with acute coronary syndrome. Methods 26 controls and 22 patients with stable angina,40 with acute coronary syndrome including 20 with unstable angina, and 20 with acute myocardial infarction were studied. Serum PAPP-A, C-RP and CK-MB levels were quantitatively determined respectively. All coronary stenosis with ≥30% diameter reduction were assessed according to angiographic coronary stenosis morphology. Results Patients with ACS had a significant increase in plasma PAPP-A level（13. 19 ±4. 04 mlU/L）, compared with the SA（5.47 ±3.00 mlU/L P 〈0. 01 ） and control group（5. 09 ± 2. 19 mlU/L P 〈0. 01 ）. A positive correlation was found between CRP（r =0. 62 P 〈0. 01 ） and PAPP-A level in patients with ACS. There was an obvious correlation between PAPP-A concentration and complex coronary stenosis （ r = 0. 45 P 〈 0. 05 ）. Conclusion The concentration of PAPP-A may reveal the instability of coronary atherosclerotic plaque, and it has implications for classifying ACS risks.

关 键 词：冠状动脉疾病/血液 急性病 综合征 妊娠相关血 浆蛋白A 冠状血管造影术 

分 类 号：R543.3[医药卫生—心血管疾病] R442.8[医药卫生—内科学]