妊娠相关蛋白A高灵敏度C反应蛋白水平对急性冠脉综合征早期诊断价值研究.docVIP

妊娠相关蛋白A高灵敏度C反应蛋白水平对急性冠脉综合征早期诊断价值研究 　　【摘要】 目的 探讨PAPP?A、hs?CRP是否可以作为评价ACS患者预后的血清学指标。方法 本研究病例选自2008年9月至2010年8月在余姚人民医院内科住院并经冠脉造影证实为冠心病的患者82例。所有研究对象均于入院次日清晨采集空腹血，同步测定血清PAPP?A、hs?CRP含量。PAPP?A的测定采用酶联免疫吸附(enzyme linked immunosorbent assay，ELISA)法，hs?CRP测定采用免疫透射比浊法。结果 所有研究对象在年龄、性别、高血压病史、吸烟史、糖尿病史、体重指数、血脂、血糖等基本临床资料方面差异无统计学意义(P0.05)。应用受试者特征曲线(receiver operating characteristic curve，ROC)对PAPP?A、hs?CRP早期诊断ACS及评价12个月预后的情况进行分析，诊断ACS时PAPP?A、hs?CRP的ROC曲线下面积分别为0.860±0.049、0.763±0.049(均有P0.01)，PAPP?A诊断ACS的灵敏度为81.32％、特异度为82.14％，hs?CRP诊断ACS的灵敏度为74.36％、特异度为65.07％。结论 PAPP?A、hs?CRP是冠心病的独立危险因子，PAPP?A与hs?CRP对ACS患者早期诊断及12个月预后评价均有重要价值，前者的综合效率高于后者。? 　　【关键词】 　　妊娠相关蛋白A；高灵敏度C反应蛋白；急性冠脉综合征 　　?? 　　Study of relativity between pregnancy? associated plasma protein A, high?sensitivity c reactive protein and acute coronary syndromes 　　 　　CHEN Lian. 　　Department of Internal Medincal,The People’s Hospital of Yuyao city,Yuyao 315400，China 　　? 　　【Abstract】 Objective 　　To investigate whether PAPP?A and hs?CRP can be better markers that stratify the risks and predict adverse outcomes in patients suffering from acute coronary syndromes. Methods The cases investigated were collected from the patients who hospitalized in the The Poeple’s Hospital of Yuyao city, from September 2008 to Auguest 2010. All the CAD patients had the final diagnosis by CAG.82 patients were collected. The fasting blood preparations of all the subjects were taken in the next morning for the concentration determination of PAPP?A and hs?CRP. The levels of PAPP?A were assayed by ELISA, and hs?CRP were assayed by immunoturbidimetry. Results The receiver operating characteristic curve(ROC) analysis was used to evaluate and compare the efficacy of biomarkers (PAPP?A and hs?CRP) in early diagnosing ACS. The area under the curve(AUC) of PAPP?A was 0.860±0.049, and the AUC of hs?CRP was 0.763±0.049. In the cutoff of 10.23 mIU/L, the sensitivity of PAPP?A in diagnosing ACS was 81.32％, and the specificity is 82.14％. In the cutoff of 2.6 mg/