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目的探讨非ST段抬高的急性冠脉综合征(Non-STelevation acute coronary syndromes,NSTEACS)患者血清妊娠相关血浆蛋白A(pregnancy associated plasma-A,PAPP-A)及胰岛素样生长因子Ⅰ(insulin-like growth factor-1,IGF-Ⅰ)浓度变化的临床意义。方法选择最终以出院诊断为标准NSTEACS患者65例,冠脉造影证实的稳定型心绞痛(stableangina pectoris,SAP)患者28例,正常对照30例。入院后12h内均抽取静脉血5ml,测定IGF-Ⅰ、PAPP-A及C反应蛋白(C-reactive protein,CRP),常规测定肌钙蛋白T(cTnT)、血脂、血糖等,各组间进行比较并进行相关性分析。结果NSTEACS患者的PAPP-A、IGF-Ⅰ、CRP明显高于SAP组和对照组(P<0.01),IGF-Ⅰ在SAP组明显低于对照组(P<0.01),而PAPP-A、CRP在SAP与对照组中无显著差异(P>0.05)。在NSTEMI组中PAPP-A与IGF-Ⅰ呈正相关,PAPP-A、IGF-Ⅰ与CRP均呈正相关,而与cTnT无明显相关性。结论PAPP-A、IGF-Ⅰ对NSTEACS具有一定的诊断、预测价值。
Objective To investigate the relationship between the serum levels of pregnancy associated plasma-A (PAPP-A) and insulin-like growth factor-Ⅰ (STAT-1) in non-STelevation of acute coronary syndromes (NSTEACS) like growth factor-1, IGF-Ⅰ). Methods Totally 65 patients were diagnosed as standard NSTEACS by discharge, 28 patients with stable angina pectoris (SAP) confirmed by coronary angiography and 30 normal controls. Intravenous blood samples were taken within 12 hours after admission and IGF-Ⅰ, PAPP-A and C-reactive protein (CRP) levels were measured. Troponin T (cTnT) Compare and conduct correlation analysis. Results The PAPP-A, IGF-Ⅰ and CRP in patients with NSTEACS were significantly higher than those in SAP group and control group (P <0.01). The levels of IGF-Ⅰ in SAP group were significantly lower than those in control group (P <0.01) There was no significant difference between SAP and control group (P> 0.05). In NSTEMI group, PAPP-A was positively correlated with IGF-I, while PAPP-A and IGF-I were positively correlated with CRP but not with cTnT. Conclusion PAPP-A and IGF-Ⅰ have some diagnostic and predictive value for NSTEACS.