血清妊娠相关血浆蛋白A与急性冠状动脉综合征的临床相关性.doc

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1、血清妊娠相关血浆蛋白A与急性冠状动脉综合征的临床相关性作者：田莉，张清华，蒋知新，陈东【关键词】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；斑块稳定性　　摘要：目的探讨急性冠脉综合征患者妊娠相关血浆蛋白A水平与高敏C反应蛋白的关系及与动脉粥样硬化斑块稳定性的关系。方法选择急性冠状动脉综合征(ACS)患者43例，稳定性心绞痛(SA)患者25例，对照组15例，进行对比分析，ACS中不稳定性心绞痛(UA)20例，急性心肌梗死(AMI)23例；心绞痛组和对照组于入院次日晨抽取外周静脉血，AMI组于发病12h内抽取静脉血。采用酶联免疫吸附法(ELISA法)检测血清妊娠相关血浆蛋

2、白(PAPPA)，散射比浊法检测C反应蛋白(CRP)浓度，进行各组间PAPPA、CRP含量比较。结果ACS组与稳定型心绞痛组和对照组之间相比，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<0.01)；妊娠相关血浆蛋白A水平与高敏C反应蛋白呈正相关(r=0.158)；多因素回归分析显示妊娠相关血浆蛋白A水平与高敏C反应蛋白呈正相关直线关系。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。　　关键词：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；斑块稳定性　　Theclinicalrelev

3、ancebetweentheserumlevelofpregnancyassociated　plasmaproteinAanddegreeofacutecoronarysyndrome　　ABSTRACT:ObjecitveToinvestigatetherelationshipbetweenthelevelofpregnancyassoiatedplasmaproteinA(PAPPA)andhighsensitivityCreactiveprotein(hsCRP)inpatientewithacutecoronarysyndrome(ACS)andtheroleofPAPPAinp

4、redictingthestabilityofatheroscleroticplaques.MethodsAtotalof43patientswereselectedasACSgroup,25patientsasstableangina(SA)and13personsascontrol.ACSgroupansistedof20patientswithunstableangina(UA)and23patientswithacutemyocardialinfarction(AMI).Theperipheralvenousbloodsamplesofthebothcontrolandangin

5、agroupsweredrawnonthemorningofthefollowingdayafterhospitalization,andoftheAMIgroupweredrawn24hoursafterepisode.TheconcentrationofPAPPAwasdetectedbyenzymelinkedimmunesorbentassay(ELISA),andtheconcentrationofCreactiveprotein(CRP)wasdetectedbyscatterturbidimetrymethod.The7concentrationofPAPPAandCRPi

6、neachgroupwascompared.ResultsTheplasmahsCRPandPAPPAlevelsinpatientswithASincreasedsignificantlycomparedwiththoseinUAandhealthyvolunteers;PAPPAwassignificantlyrelatedwithhsCRP(r=0.308);usingthemethodofmultipleregressionandcorrelationPAPPAhadlinearrelationshipwithhsCRPinallofthecases.ConclusionPAPP

7、Acanplayaroleinevaluatingtheclinicalstabilityofpatientswithcoronarydisease,andmayserveasoneofthebiomarkersofvulnerableplaques.　　KEYWORDS:unstableangina;pregnancyassociatedplasmaproteinA;highsensitivityCreactiveprotein;