不稳定型心绞痛患者血清妊娠相关蛋白A与颈动脉粥样硬化的相关性被引量：12

The relevance between carotid atherosclerosis and serum pregnancy-associated protein A of unstable angina patients

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摘要目的探讨颈动脉粥样硬化、血清妊娠相关性蛋白A与不稳定型心绞痛、稳定型心绞痛、非冠心病的相关性。方法因胸痛入院的患者1 w内行冠脉造影,排除急性及亚急性心梗后,不稳定型心绞痛、稳定型心绞痛、非冠心病各40例被纳入研究中,进行冠状动脉Gensini评分;彩超检测颈动脉内中膜厚度、斑块形成情况,应用酶联免疫吸附法测定血清妊娠相关蛋白A水平,并进行统计学分析。结果除吸烟史外,各组间其余基线资料匹配;不稳定型心绞痛、稳定型心绞痛的冠脉Gensini评分、颈动脉粥样硬化指标均较非冠心病高(P<0.001);不稳定型心绞痛组比稳定型心绞痛及非冠心病组血清妊娠相关蛋白A的浓度高(P<0.001),妊娠相关蛋白A在不稳定型心绞痛患者明显升高,其与颈动脉粥样硬化指标、冠脉Gensini积分正相关;Crouse积分预测心绞痛型冠心病,敏感度、特异度分别为0.79、0.92;颈动脉内中膜厚度平均值预测心绞痛型冠心病敏感度、特异度分别为0.97、0.85;妊娠相关蛋白A预测不稳定型心绞痛敏感度、特异度分别为0.825、0.937。结论颈动脉粥样硬化指标与冠状动脉Gensini积分有较好的相关性,而妊娠相关蛋白A可作为预测不稳定型心绞痛的指标;二者联合检测可能是预测不稳定型心绞痛的重要临床依据。 Objective To investigate the relevance between carotid atherosclerosis, serum pregnancy-associated protein A （PAPP- A） and the incidence of unstable angina （ UAP）, stable angina pectoris （ SAP）, Non-coronary heart disease （ NCHD）, to further discuss joint significance of carotid atherosclerosis and PAPP-A concentration in the forecast of UAP. Methods Patients admitted to hospital because of chest pain,coronary angiography were completed within 1 w, which with acute and subacute myocardial infarction had been excluded, then, 40 case of UAP,40 cases of SAP,40 cases of NCHD were taken. Gensini score, intima-media thickness（IMT） of carotid artery , plaque formation of carotid artery were determined by color doppler ultrasound, serum levels of PAPP-A was determined by enzyme-linked immunosorbent assay （ELISA）. Results In. addition to smoking history, baseline informations of the groups were matched each other; coronary Gensini score, indicators of carotid atherosclerosis of UAP and SAP groups were higher than those of NHCD group（ P 〈 0. 001 ） ; serum concentration of PAPP-A of UAP was higher than that of SAP and NHCD groups （P 〈 0. 001 ） ; PAPP-A in patients with UAP was significantly higher, and its concentration was correlated with indicators of carotid atherosclerosis, coronary artery Gensini score. The sensitivity and specificity of Crouse score predicting angina-type CHD were 0.79,0. 92 respectively; the sensitivity and specificity of average of Carotid IMT predicting angina-type CHD were 0. 97,0. 85 respectively; the sensitivity and specificity of PAPP-A predicting UAP were 0. 825,0. 937 respectively. Conclusions Indicators of carotid atherosclerosis and coronary artery Gensini score have good correlation, and PAPP-A as a predictable indicator of UAP; the two indicators may be important clinical basis to predict UAP.

作者刘克坚罗春生邱强刘诚唐斌

机构地区石河子大学医学院第一附属医院心内一科新疆石河子大学医学院第一附属医院功能科

出处《中国老年学杂志》 CAS CSCD 北大核心 2012年第14期2918-2920,共3页 Chinese Journal of Gerontology

基金国家自然科学基金资助项目(No.30860079)

关键词不稳定型心绞痛妊娠相关蛋白A 颈动脉粥样硬化 GENSINI积分 Crouse积分 Carotid atherosclerosis Pregnancy-associated protein A Unstable angina Gensini score Crouse score

分类号 R541.4 [医药卫生—心血管疾病]

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