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目的:探讨血清妊娠相关蛋白-A(PAPP-A)水平在急性冠状动脉综合征(ACS)患者中的变化;评价PAPP-A与ACS近期临床预后的相关性。方法:以ELISA法检测70例ACS患者、23例稳定型心绞痛(SAP)患者和21例健康人(对照组)血清PAPP-A水平,并根据血清PAPP-A水平,将70例ACS患者分为3组:A组:血清PAPP-A水平≤10mIU/L,B组:<10mIU/L血清PAPP-A水平≤20mIU/L,C组:血清PAPP-A水平>20mIU/L。随访各组1、3、6个月的与ACS相关的病死率及主要不良心脏事件(MACE)发生率。结果:ACS患者血清中PAPP-A含量均显著高于对照组和SAP组(P<0.01)。70例ACS患者中,各组病死率及MACE发生率随血浆PAPP-A水平的升高呈明显递增趋势。ACS发病1个月时,各组病死率和MACE发生率均为0%。3个月时,A组、B组及C组病死率分别为0%、1.9%、3.8%;MACE发生率分别为0%、1.9%、5.7%。6个月时,A组、B组及C组病死率分别为0%、5.2%、5.2%;MACE发生率分别为5.2%、5.2%、10.5%。结论:ACS患者血清PAPP-A水平的升高,与患者近期的病死率和MACE发生率具有一定的相关性。因此,血清PAPP-A有望成为一个预测ACS患者近期临床预后的良好指标。
Objective: To investigate the change of serum level of pregnancy-associated protein-A (PAPP-A) in patients with acute coronary syndrome (ACS) and to evaluate the correlation between PAPP-A and the recent clinical prognosis of ACS. Methods: The serum levels of PAPP-A in 70 patients with ACS, 23 patients with stable angina pectoris (SAP) and 21 healthy people (control group) were detected by ELISA. According to the level of serum PAPP-A, 70 ACS patients were divided into Group 3: Group A: serum PAPP-A level ≤10mIU / L, Group B: <10mIU / L serum PAPP-A level ≤20mIU / L, Group C: serum PAPP-A level> 20mIU / L. The 1,3-month and 6-month ACS-related mortality rates and major adverse cardiac events (MACE) were followed up. Results: The serum levels of PAPP-A in patients with ACS were significantly higher than those in control group and SAP group (P <0.01). 70 cases of ACS patients, the mortality of each group and the incidence of MACE with plasma PAPP-A levels increased significantly. One month after onset of ACS, the morbidity of each group and the incidence of MACE were 0%. At 3 months, the mortality rates in groups A, B and C were 0%, 1.9% and 3.8%, respectively. The incidence of MACE was 0%, 1.9% and 5.7%, respectively. At 6 months, the mortality rates in groups A, B and C were 0%, 5.2% and 5.2%, respectively. The incidence of MACE was 5.2%, 5.2% and 10.5%, respectively. Conclusions: The increase of serum PAPP-A level in patients with ACS is related to the recent mortality and the incidence of MACE. Therefore, serum PAPP-A is expected to be a good predictor of recent clinical outcomes in patients with ACS.