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目的研究急性冠状动脉综合征(ACS)患者血清妊娠相关血浆蛋白A(PAPP-A)的变化及其与血清高敏C-反应蛋白(hsCRP)和肿瘤坏死因子-α(TNF-α)水平的相关性。方法测定18例不稳定型心绞痛(UAP组)、37例急性心肌梗死(AMI组)和15例稳定型心绞痛(SAP组)及15例正常对照者的血清PAPP-A、hsCRP、TNF-α水平。结果SAP组血清PAPP-A水平与正常对照组相比,差异无统计学意义(P>0.05);UAP组和AMI组血清PAPP-A水平均显著高于正常对照组(P<0.01)和SAP组(P<0.01),但UAP组与AMI组相比,差异无显著性。cTnT阴性ACS组患者血清PAPP-A水平也明显高于正常对照组(P<0.01)和SAP组(P<0.05)。SAP组血清hsCRP和TNF-α水平明显高于正常对照组;UAP组明显高于正常对照组和SAP组,但低于AMI组。单因素直线相关分析显示,ACS组患者的血清PAPP-A水平与hsCRP和TNF-α水平呈显著正相关(r=0.616、0.712,P<0.01)。结论PAPP-A与炎症密切相关,在识别没有cT-nT升高的ACS患者方面有重要临床应用价值。
Objective To study the changes of serum pregnancy-associated plasma protein A (PAPP-A) and the correlation with serum hs-CRP and TNF-α in patients with acute coronary syndrome (ACS) Sex. Methods Serum levels of PAPP-A, hsCRP and TNF-α in 18 cases of unstable angina pectoris (UAP group), 37 cases of acute myocardial infarction (AMI group) and 15 cases of stable angina pectoris (SAP group) and 15 normal controls . Results There was no significant difference in PAPP-A level between SAP group and normal control group (P> 0.05). Serum PAPP-A levels in SAP group and SAP group were significantly higher than those in normal control group (P <0.01) Group (P <0.01), but there was no significant difference between UAP group and AMI group. Serum PAPP-A levels in patients with cTnT-negative ACS were also significantly higher than those in normal controls (P <0.01) and SAP groups (P <0.05). Serum levels of hsCRP and TNF-α in SAP group were significantly higher than those in normal control group. UAP group was significantly higher than that in normal control group and SAP group, but lower than AMI group. One-way linear correlation analysis showed that the level of serum PAPP-A in patients with ACS was positively correlated with the levels of hsCRP and TNF-α (r = 0.616,0.712, P <0.01). Conclusions PAPP-A is closely related to inflammation and has important clinical value in identifying ACS patients without elevated cT-nT.