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目的探讨冠心病患者血清妊娠相关血浆蛋白A(PAPP-A)、血清新蝶呤(NPT)水平与冠状动脉不稳定斑块的相关性。方法应用ELISA方法检测正常对照(C组,31例)、稳定型心绞痛(SA组,41例)、不稳定型心绞痛(UA组,61例)患者血清PAPP-A、NPT水平。冠状动脉造影检测冠脉复杂狭窄数量。结果 UA组血清PAPP-A、NPT水平分别为(12.17±3.08)μg/L、(9.27±3.01)μg/L,明显高于SA组的(8.38±3.31)μg/L、(7.16±3.60)μg/L和对照组的(4.71±3.09)μg/L、(5.01±1.70)μg/L(P<0.01);UA组血清PAPP-A水平和NPT呈显著正相关(r=0.45,P<0.01);在SA组和C组血清PAPP-A水平和NPT无明显相关性(P>0.05)。UA组冠脉复杂狭窄数明显大于SA组和C组(P<0.01);UA组血清PAPP-A、NPT水平均与冠脉复杂狭窄数呈正相关(r1=0.51,r2=0.36,P<0.01)。结论冠心病患者血清PAPP-A与NPT水平升高提示冠脉斑块不稳定,可能是冠脉病变活动性的指标。
Objective To investigate the correlation between serum pregnancy-associated plasma protein A (PAPP-A) and serum neopterin (NPT) levels and unstable coronary plaque in patients with coronary heart disease. Methods Serum levels of PAPP-A and NPT in patients with stable angina (group SA, n = 41) and unstable angina (group UA, n = 61) were measured by ELISA. Coronary angiography to detect the number of complex coronary stenosis. Results The serum levels of PAPP-A and NPT in UA group were (12.17 ± 3.08) μg / L and (9.27 ± 3.01) μg / L respectively, which were significantly higher than those in SA group (8.38 ± 3.31 μg / L, 7.16 ± 3.60) (4.71 ± 3.09) μg / L and (5.01 ± 1.70) μg / L respectively in the control group (P <0.01). The level of PAPP-A in the UA group was positively correlated with NPT (r = 0.45, P < 0.01). There was no significant correlation between PAPP-A level and NPT in SA group and C group (P> 0.05). The number of coronary artery stenosis in UA group was significantly higher than that in SA group and C group (P <0.01). The serum PAPP-A and NPT levels in UA group were positively correlated with the number of coronary stenosis (r1 = 0.51, r2 = ). Conclusions The elevated serum levels of PAPP-A and NPT in patients with coronary heart disease suggest that coronary plaque is unstable and may be an indicator of coronary artery disease activity.