妊娠相关蛋白-A与冠状动脉斑块形态关系的临床研究  

Relationship between pregnancy-associated plasma protein A and the morphology of atherosclerotic plaque in coronary artery

作　　者：刘志远[1] 张金盈[2] 李纲[1] 韩学华[1] 李玉东[1] 

机构地区：[1]南阳市中心医院心内科,河南省473009 [2]郑州大学第一附属医院心内科

出　　处：《中国心血管病研究》2007年第9期641-643,共3页Chinese Journal of Cardiovascular Research

基　　金：河南省自然科学基金资助项目(0511041900)

摘　　要：目的探讨冠心病患者妊娠相关蛋白-A(PAPP-A)与冠状动脉斑块形态的关系及斑块的稳定性。方法42例冠心病患者分为急性心肌梗死(AMI)组12例,不稳定型心绞痛(UAP)组15例,稳定型心绞痛(SAP)组15例,均行冠状动脉造影(CAG)确诊,16例CAG结果正常者为对照组。采用酶联免疫吸附法(ELISA)测定其PAPP-A水平,分析与冠状动脉斑块形态的关系。结果PAPP-A在AMI组、UAP组、SAP组和对照组中浓度分别为(16.85±10.30)mIU/L、(15.24±10.51)mIU/L、(8.51±3.10)mIU/L和(8.35±2.01)mIU/L;在AMI和UAP组PAPP-A水平明显高于SAP和对照组(P<0.01),但在AMI组与UAP组、SAP和对照组之间差异无统计学意义(P>0.05)。PAPP-A在Ⅱ型斑块组明显高于Ⅰ型、Ⅲ型斑块组(P<0.01),Ⅱ型斑块在AMI组、UAP组中的发生率明显高于SAP组(P<0.01)。结论PAPP-A参与动脉硬化粥样斑块的发生发展过程,可作为预测斑块稳定性的标志物。Ⅱ型斑块易破裂。Objective To investigate the relationship between pregnancy-associated plasma protein A （PAPP-A） and the morphology of atherosclerotic plaque in coronary artery. Methods 42 patients with CHD were divided into the acute myocardial infarction（AMI）group（n = 12）,the unstable angina pectoris （UAP） group （n= 15 ） and the stable angina pectofis（SAP） group（n=15）,by coronary angiography（CAG）, 16 normal subjects without CHD diagnosed by CAG served as the control group. The serum level of PAPP-A by enzyme linked immunosorbent assay （ELISA）, the relationships between PAPP-A and the morphology of atherosclerotic plaque in coronary artery were analyzed. Results In AMI, UAP,SAP and the control group,the mean level of serum PAPP-A was （16.85± 10.30）mIU/L, （ 15.24±10.51 ）mIU/L, （8.51±3.10）mIU/L and （8.35±2.01）mIU/L, the mean level of serum PAPP-A was obviously higher in the AMI and UAP group than in the SAP and control group （P〈0.01）, but there were no significant differences in AMI group and UAP group,in SAP group and in control group（P〉0.05）. The serum level of PAPP-A in type Ⅱ plaque group were obviously higher than that type Ⅰ , Ⅲ plaque group（P〈0.01 ）. The incidence of type Ⅱ plaque was obviously higher in the AMI and UAP group than in the SAP group （P〈0.01）. Conclusion PAPP-A can play role in the occurance and development of atheromatous plaque and probably act as one of the biomarkera of vulnerable plaques, type Ⅱ plaque may prone to rupture.

关 键 词：妊娠相关α血浆蛋白质 冠状动脉 冠状动脉疾病 

分 类 号：R541.4[医药卫生—心血管疾病]