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目的:探讨血清妊娠相关血浆蛋白A(PAPP-A)在急性冠状动脉综合征(ACS)危险分层和预后判断的意义。方法:采用时间分辨免疫荧光分析法检测63例ACS患者入院时血清PAPP-A水平,观察3月时患者发生主要不良心血管事件的情况。应用受试者工作特征曲线确定血清PAPP-A水平截断点,根据该值将患者危险分层,分为高危组和低危组。结果:血清PAPP-A水平危险分层的最佳截断点取15.3 mU/L,其敏感性73.68.0%,特异性59.09%。高危组中发生不良心血管事件为42.42%,而无事件者为57.58%;低危组中分别为16.67%和83.33%。高危组预后情况较低危组更差(P<0.05)。结论:血清PAPP-A水平可能是ACS患者有价值的预测指标,对筛选ACS患者中高危患者具有一定使用价值。
Objective: To investigate the significance of serum pregnancy-associated plasma protein A (PAPP-A) in risk stratification and prognosis of acute coronary syndrome (ACS). Methods: The serum levels of PAPP-A at admission were measured in 63 cases of ACS patients by time-resolved immunofluorescence assay. The incidence of major adverse cardiovascular events in March was observed. The receiver operating characteristic curve was used to determine the cut-off point of serum PAPP-A level. According to the value, the patients’ risk stratification was divided into high-risk group and low-risk group. Results: The optimal cut-off point of serum level of PAPP-A was 15.3 mU / L, with a sensitivity of 73.68% and a specificity of 59.09%. The incidence of adverse cardiovascular events in the high-risk group was 42.42% compared to 57.58% for those who did not, and 16.67% and 83.33% for the low-risk group, respectively. The prognosis of the high risk group was worse than that of the low risk group (P <0.05). Conclusion: Serum PAPP-A level may be a valuable predictor of ACS patients, and has certain value in screening high-risk patients with ACS.