【摘要】 目的:探讨急性冠脉综合征(ACS)患者血管内超声(IVUS)显像与血清淀粉样蛋白A(SAA)、妊娠相关血浆蛋白A(PAPP-A)浓度的相关性。方法:按照1979年WHO缺血性心脏病诊断标准选择80例住院冠心病患者,分为稳定型心绞痛(SAP)组(20例)和ACS组(60例),所有患者均行IVUS、冠脉造影检查,术前至少1h分别检测患者血清SAA、血浆PAPP-A的浓度,并与IVUS检查所得出的斑块纤维帽厚度、偏心指数、重构指数比较,分析其相关性。结果:与SAP组患者相比,ACS组患者纤维帽厚度明显变薄[(1.0±0.2)mm∶(0.7±0.1)mm],偏心指数[(0.4±0.1)∶(0.9±0.2)]、重构指数明显提高[(0.8±0.1)∶(1.3±0.2)],SAA[(13.75±9.65)MIU/L∶(36.4±12.32)MIU/L]、PAPP-A[(10.36±8.25)mg/L∶(32.68±12.5)mg/L]浓度明显升高(P均<0.001)。SAA、PAPP-A水平与纤维帽厚度均呈负相关(r=-0.68,-0.68,P均<0.05),与偏心指数(r=0.75,0.81)、重构指数(r=0.71,0.78)呈正相关(P均<0.05)。结论:急性冠脉综合征患者易损斑块的纤维帽厚度、偏心指数、重构指数(斑块稳定性)与血清淀粉样蛋白A、妊娠相关蛋白A存在相关关系,血清淀粉样蛋白A、妊娠相关蛋白A可作为预测易损斑块稳定性的重要指标。更多还原

【Abstract】 Objective: To explore the correlation between plaque image characteristics detected by intravascular ultrasound(IVUS) in patients with acute coronary syndrome(ACS) and levels of serum amyloid protein A(SAA) and pregnancy-associated plasma protein A(PAPP-A).Methods: According to WHO diagnostic standard of ischemic heart diseases(IHD)in 1979,a total of 80 IHD inpatients were enrolled and divided into stable angina pectoris(SAP) group(n=20) and ACS group(n=60).All patients underwent coronary angiograph(CAG) and IVUS,and concentrations of SAA and PAPP-A were measured at 1h before CAG.Their correlation with fibrous cap thickness of plaque,eccentricity index(EI) and remodeling index(RI) measured by IVUS were analyzed.Results: Compared with SAP group,fibrous cap thickness of plaque [(1.0±0.2)mm vs.(0.7±0.1)mm] significantly decreased,EI [(0.4±0.1) vs.(0.9±0.2)] and RI [(0.8±0.1) vs.(1.3±0.2)] significantly increased,concentrations of SAA [(13.75±9.65) MIU/L vs.(36.4±12.32) MIU/L] and PAPP-A [(10.36±8.25)mg/L vs.(32.68±12.5) mg/L] significantly increased in ACS group(P<0.001 all).Levels of SAA and PAPP-A were negatively correlated with fibrous cap thickness(r=-0.68,-0.68,P<0.05 all),and positively correlated with EI(r=0.75,0.81) and RI(r=0.71,0.78),P<0.05 all.Conclusion: There is a relationship among serum levels of SAA and PAPP-A and fibrous cap thickness,eccentricity index and remodeling index(stability of vulnerable plaque)in patients with ACS,so values of SAA and PAPP-A may be valuable to predict the stability of vulnerable plaque.更多还原