急性冠状动脉综合征妊娠相关血浆蛋白-A与C反应蛋白和肿瘤坏死因子-α相关性的研究  

Study of pregnancy-associated plasma protein A,C-reactive protein and tumor necrosis factor-α in acute coronary syndromes

作　　者：李卫萍[1] 贾三庆[1] 顾复生[1] 

机构地区：[1]首都医科大学附属北京友谊医院心血管中心,北京100050

出　　处：《临床心血管病杂志》2007年第11期822-825,共4页Journal of Clinical Cardiology

摘　　要：目的:研究急性冠状动脉综合征(ACS)患者妊娠相关血浆蛋白A(PAPP-A)血清水平和外周血单核细胞表达的变化及其与C反应蛋白(CRP)和肿瘤坏死因子-α(TNF-α)的相关性。方法:测定18例不稳定型心绞痛(UAP组)、37例急性心肌梗死(AMI组)和15例稳定型心绞痛(SAP组)及15例正常对照者(对照组)的血清PAPP-A、高敏CRP(hsCRP)和TNF-α水平。同时分离外周血单核细胞,应用RT-PCR检测PAPP-A和TNF-α的mRNA表达。结果:SAP组血清hsCRP和TNF-α水平明显高于对照组;UAP组明显高于对照组和SAP组,但低于AMI组。SAP组血清PAPP-A水平和单核细胞PAPP-A的mRNA表达水平与对照组相比,差异无统计学意义;而在UAP组和AMI组均显著高于对照组和SAP组(均P<0.01)。ACS组患者的血清PAPP-A水平与血清hsCRP和TNF-α水平均呈显著正相关(r=0.616,r=0.712,P<0.01),同时外周血单核细胞PAPP-AmR-NA表达水平与血清hsCRP水平及TNF-αmRNA表达水平均呈显著正相关(r=0.706,r=0.733,P<0.01)。结论:PAPP-A可能是由活化的单核细胞合成并分泌到动脉粥样硬化斑块内和血循环中,并与炎症密切相关。Objective：To study the changes of serum pregnancy-associated plasma protein-A（PAPP-A） and expression of PAPP-A on peripherial blood monocytes in patients with acute coronary syndromes（ACS） and its correlation with C-reactive protein （CRP） and tumor necrosis factor-α（TNF-α）. Method： There were eighteen patients with unstable angina （UAP）, thirty-seven patients with acute myocardial infarction（AMI）, fifteen patients with stable angaina （SAP） and fifteen healthy subjects in the study. Levels of serum PAPP-A, hsCRP and TNF-a were measured. Peripherial blood monocytes were isolated by Ficoll. Expressions of PAPP-A and TNF-α on peripherial blood monocytes were analyzed by RTPCR. Result：Serum hsCRP and TNF-α levels were significantly higher in UAP patients or AMI patients than in SAP patients and controls. Serum level and mRNA expression of PAPP-A were significantly higher in UAP patients or AMI patients than in SAP patients and controls （P〈0. 01）. The level of serum PAPP-A in ACS patients was positively correlated with serum hsCRP and TNF-α levels （r=0. 616, 0. 712, P〈0. 01）, and mRNA expression of PAPP-A in peripherial blood monolytes was also positively correlated with serum hsCRP level and mRNA expression of TNF-α （ r = 0. 706, 0. 733, P〈0. 01）. Conclusion：PAPP-A which is produced and secreted by active monocytes is associated with inflammation to plaque and circulation, by actived monocytes.

关 键 词：急性冠状动脉综合征 妊娠相关血浆蛋白A C反应蛋白 肿瘤坏死因子-Α 

分 类 号：R544.2[医药卫生—心血管疾病]