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目的:探讨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)水平与可溶性OX40配体(sOX40L)及单核细胞表达OX40L水平之间的相关性。方法:应用双抗夹心酶联免疫测定法(ELISA)分别对冠状动脉造影正常对照组(30例)、稳定型心绞痛(SA)组(60例)、不稳定型心绞痛(UA)组(50例)、急性心肌梗死(AMI)组(30例)患者血清PAPP-A及sOX40L水平进行检测,采用流式细胞术检测患者血单核细胞表达OX40L水平。结果:血清sOX40L、PAPP-A水平UA组[(15.7±4.9)μg/L,(25.4±6.8)mg/L]及AMI组[(17.1±5.3)μg/L,(26.3±5.6)mg/L]明显高于SA组[(3.4±1.4)μg/L,(9.6±2.1)mg/L]及对照组[(3.9±1.3)μg/L,(8.5±2.8)mg/L];循环血单核细胞表达OX40LUA组[(25.6±5.5)MFI]及AMI组[(29.4±6.3)MFI]明显较SA组[(10.6±2.8)MFI]及对照组[(11.1±3.5)MFI]高。ACS患者血清PAPP-A水平与sOX40L及单核细胞表达OX40L呈显著正相关(r1=0.54,r2=0.51;P<0.0001);ACS患者血清PAPP-A、sOX40L水平及单核细胞表达OX40L均与冠状动脉复杂狭窄程度呈正相关(r1=0.56,r2=0.55,r3=0.40;P<0.001)。结论:ACS患者血清PAPP-A水平与sOX40L及单核细胞表达OX40L相关,二者共同高表达提示冠状动脉斑块不稳定,可能是ACS活动性标志物。
Objective: To investigate the correlation between serum pregnancy-associated plasma protein-A (PAPP-A) levels and the levels of soluble OX40 ligand (sOX40L) and monocyte-derived OX40L in patients with acute coronary syndrome (ACS). Methods: The normal control group (30 cases), stable angina pectoris group (60 cases), unstable angina pectoris group (50 cases) ), And the levels of PAPP-A and sOX40L in acute myocardial infarction (AMI) group (30 cases). The levels of OX40L in blood mononuclear cells were detected by flow cytometry. Results: Serum levels of sOX40L and PAPP-A were significantly higher in UA group ([(15.7 ± 4.9) μg / L, (25.4 ± 6.8) mg / L] and AMI group (17.1 ± 5.3 μg / L, 26.3 ± 5.6 mg / L was significantly higher than that in SA group [(3.4 ± 1.4) μg / L, (9.6 ± 2.1) mg / L] and control group (3.9 ± 1.3 μg / L, Compared with SA group [(10.6 ± 2.8) MFI] and control group [(11.1 ± 3.5) MFI], the expression of [25.6 ± 5.5 MFI] and AMI group [(29.4 ± 6.3) MFI] . The level of PAPP-A in patients with ACS was significantly and positively correlated with the expression of OX40L in sOX40L and monocytes (r1 = 0.54, r2 = 0.51; P <0.0001). The levels of PAPP-A and sOX40L in serum and the expression of OX40L in mononuclear cells Coronary complex stenosis was positively correlated (r1 = 0.56, r2 = 0.55, r3 = 0.40; P <0.001). Conclusion: The serum level of PAPP-A in patients with ACS is correlated with the expression of OX40L in sOX40L and monocytes. The high level of PAPP-A in ACS patients suggests that the coronary plaque is unstable and may be the marker of ACS activity.