急性冠状动脉综合征患者妊娠相关血浆蛋白A的变化  

Change of pregnancy associated plasma protein-A levels in patients with acute coronary syndrome

作　　者：王月海 蔡运昌 杨天和 张陈匀 吴强 

机构地区：[1]临清市人民医院心内科,山东临清252600 [2]贵州省心血管病医院心内科

出　　处：《临床心血管病杂志》2009年第11期817-820,共4页Journal of Clinical Cardiology

摘　　要：目的:观察急性冠状动脉综合征(ACS)患者妊娠相关血浆蛋白A(PAPP-A)水平的变化。方法:冠状动脉造影(CAG)证实的冠心病患者80例,分为ACS组(53例)、稳定型心绞痛(SA)组(27例),以23例CAG正常者为正常对照组;测定各组患者入院时外周血清PAPP-A水平,分析不同组别间及ACS组、SA组中冠状动脉病变不同程度者PAPP-A水平的变化,并分析PAPP-A水平与TnT、CK-MB的相关性。结果:①ACS组的PAPP-A水平显著高于正常对照组和SA组(P<0.01),正常对照组与SA组之间及ACS组中不稳定型心绞痛和急性心肌梗死亚组PAPP-A水平比较差异均无统计学意义(P>0.05);②PAPP-A水平与CK-MB、TnT水平无显著相关;③ACS组、SA组中冠状动脉病变不同程度亚组PAPP-A水平比较差异均无统计学意义(P>0.05)。结论:检测PAPP-A水平对ACS早期诊断可能有一定的意义,但冠状动脉病变程度与PAPP-A水平无显著相关。Objective：To observe the changes of PAPP-A level of different clinical spectra patients with coronary artery disease（CAD） . Method：Eighty patients with CAD diagnosed by coronary angiography（CAG）, including 27 cases with stable pectoris（SA）, 31 cases with unstable pectoris（UA） and 22 cases with acute myocardial infarction（AMI） and 23 non-CAD cases were studied. The patients are also divided single, double and three-vessel lesion groups and reckoned corresponding to Jenkin＇s scores which reflect the degree of pathological changes; The blood serum of all objects were collected on admission for measure of PAPP-A, CK-MB and TnT. The PAPP-A levels among different groups was analyzed and compared. So were the correlation between PAPP-A levels and TnT or CKMB levels. Result：（1） The PAPP-A levels of AMI and UA group is significantly higher than that of SA and NON-CAD group （P〈0. 01）, while there is no significant difference between AMI and UA group, nor between SA and NON-CAD group （P〉0.05）. （2）There is no correlation between PAPP-A levels and TnT or CKMB levels. （3）There is no significant difference of the PAPP-A level among the different extent of coronary pathological change in CAD patients（P〉0. 05）. Conclusion：The PAPP-A level may be a biomarker of early diagnosis for ACS patients, though there is no correlation between the degree of pathological change and the PAPP-A level.

关 键 词：急性冠状动脉综合征 妊娠相关血浆蛋白A 不稳定斑块 

分 类 号：R542.2[医药卫生—心血管疾病]