【摘要】 目的分析冠状动脉粥样硬化性心脏病(冠心病)患者血清妊娠相关血浆蛋白A(PAPP-A)与胰岛素样生长因子Ⅰ(IGF-Ⅰ)的表达及两者联合检测的临床意义。方法回顾性分析新疆医科大学第一附属医院自2017年1月至2018年1月治疗的171例经冠状动脉(冠脉)造影验证的冠心病患者临床资料,其中稳定型心绞痛(SAP)组63例、不稳定型心绞痛(UAP)组56例、急性心肌梗死(AMI)组52例;选取同期的50名冠脉造影正常者为对照组;比较各组血清PAPP-A、IGF-Ⅰ、高敏C-反应蛋白(hs-CRP)和肌钙蛋白T(cTnT)水平并进行Pearson相关性分析。结果 AMI组、UAP组血清PAPP-A、IGF-Ⅰ、hs-CRP水平均高于SAP组和对照组,差异均有统计学意义(P<0.05);SAP组与对照组血清PAPP-A、hs-CRP比较,差异均无统计学意义(P>0.05);SAP组血清IGF-Ⅰ水平低于对照组,差异有统计学意义(P<0.05);AMI组血清cTnT水平高于UAP组、SAP组和对照组,差异均有统计学意义(P<0.05);UAP组、SAP组和对照组间血清cTnT水平比较,差异均无统计学意义(P>0.05);冠心病患者PAPP-A、IGF-Ⅰ、hs-CRP和cTnT的相关性分析显示:PAPP-A与IGF-Ⅰ呈正相关(P<0.05),PAPP-A与hs-CRP呈正相关(P<0.05),IGF-Ⅰ与hs-CRP呈正相关(P<0.05),PAPP-A、IGF-Ⅰ、hsCRP与cTnT无相关性(P值均>0.05)。结论冠心病患者病变程度与血清PAPP-A和IGF-Ⅰ表达水平呈正相关,可能与PAPP-A和IGF-Ⅰ协同降低冠脉粥样硬化斑块稳定性有关,值得进一步研究应用。更多还原

【Abstract】 Objective To analyze the expressions of pregnancy-associated plasma protein A(PAPP-A) and insulin-like growth factor-1(IGF-Ⅰ) and clinical significance of their combined detection in patients with coronary heart disease(CHD). Methods CHD patients diagnosed by coronary angiography(CAG) were chosen(n=171) from the First Affiliated Hospital of Xinjinang Medical University from Jan. 2017 to Jan. 2018, and divided into group of stable angina pectoris(SAP group, n=63), group of unstable angina pectoris(UAP group, n=56) and group of acute myocardial infarction(AMI group, n=52). The patients with normal CAG results(n=50) were chosen into control group. The levels of PAPP-A, IGF-Ⅰ, high-sensitivity C-reactive protein(hs-CRP) and cardiac troponin T(cTnT)were compared and analyzed by using Pearson correlation analysis in all groups. Results The levels of serum PAPP-A, IGF-Ⅰ and hs-CRP were all higher in AMI group and UAP group than those in SAP group and control group(P<0.05). The comparison in levels of serum PAPP-A and hs-CRP had no statistical difference between SAP group and control group(P>0.05). The level of IGF-Ⅰ was lower in SAP group than that in control group(P<0.05),and level of cTnT was higher in AMI group than that in UAP group, SAP group and control group(P<0.05). The difference in level of cTnT had no statistical significance among UAP group, SAP group and control group(P>0.05).The correlation analysis on PAPP-A, IGF-Ⅰ, hs-CRP and cTnT showed that PAPP-A was positively correlated to IGF-Ⅰ(P<0.05), PAPP-A was positively correlated to hs-CRP(P<0.05), IGF-Ⅰ was positively correlated to hsCRP(P<0.05), and PAPP-A, IGF-Ⅰ and hs-CRP was no correlated to cTnT(all P>0.05). Conclusion The severity of coronary artery lesions is positively correlated to levels of PAPP-A and IGF-Ⅰ in CHD patients, which may be related to that PAPP-A and IGF-Ⅰ can jointly reduce atherosclerotic plaque stability.更多还原