血清妊娠相关血浆蛋白A及急性冠状动脉综合征临床相关性.docVIP

血清妊娠相关血浆蛋白A及急性冠状动脉综合征临床相关性 　 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(Plt;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 　　The clinical relevance between the serum level of pregnancyassociated　plasma proteinA and degree of acute coronary syndrome 　　ABSTRACT: Objecitve To investigate the relationship between the level of pregnancyassoiated plasma proteinA (PAPPA) and highsensitivity Creactive protein (hsCRP) in patiente with acute coronary syndrome (ACS) and the role of PAPPA in predicting the stability of atherosclerotic plaques. Methods A total of 43 patients were selected as ACS group, 25 patients as stable angina (SA) and 13 persons as control. ACS group ansisted of 20 patients with unstable angina (UA) and 23 patients with acute myocardial infarction (AMI). The peripheral venous blood samples of the both control and angina groups were drawn on the morning of the following day after hospitalization, and of the AMI group were drawn 24 hours after episode. The concentration of PAPPA was detected by enzymelinked immune sorbent assay (ELISA), and the concentration of Creactive protein (CRP) was detected by scatter turbidimetry method. The concentration of PAPPA and CRP in each group was compared. Results The plasma hsCRP and PAPPA levels in patients with AS increased significantly compared with those in UA and healthy volunteers; PAPPA was significantly related with hsCRP (r=0.308); using the method of multiple regression and correlation PAPPA had linear relationship with hsCRP in all of the cases. Conclusion P