【摘要】：目的:急性冠脈綜合征(acute coronary syndrome,ACS)是一種嚴重危害人類健康的疾病,近年來研究發(fā)現(xiàn)炎癥反應在動脈粥樣硬化斑塊的發(fā)生發(fā)展中起重要作用。而其中,妊娠相關血漿蛋白A(pregnancy associated plasma protein A,PAPP-A)是目前的研究熱點之一。本研究通過對ACS患者PAPP-A以及ACS相關的生物標志物白細胞介素-6(interleukin-6,IL-6)、血漿高敏C反應蛋白(high sensitivity C reactive protein,hs-CRP)、可溶性白細胞分化抗原40配體(soluble CD40 ligand,sCD40L)和B型鈉尿肽(brain natriuretic peptide,BNP)的檢測,探討PAPP-A在急性冠脈綜合癥中的臨床價值及與hs-CRP、sCD40L、BNP及IL-6相關性。方法:1.本研究選取2015年12月到2016年6月蚌埠醫(yī)學院第一附屬醫(yī)院心內(nèi)科診斷為ACS的患者169名,其中男性患者116名,女性患者53名,并將其分為心肌梗死(acute myocardial infarction,AMI)組和不穩(wěn)定型心絞痛(unstable angina,UA)組。另外從體檢人群中選取60名健康人員作為對照組。2.所有患者均在入院次日凌晨,體檢者在體檢當日早晨空腹采集靜脈血,經(jīng)抗凝、離心分離血漿,-70℃保存待測。采用電化學發(fā)光法檢測PAPP-A和IL-6;免疫比濁法檢測hs-CRP;ELISA法檢測sCD40L;化學發(fā)光法檢測BNP。3.本次研究應用SPSS19.0進行數(shù)據(jù)儲存,并分析不同組間PAPP-A及IL-6、BNP、hs-CRP、sCD40L水平的差異,當P0.05時認為差異具有統(tǒng)計學意義。結(jié)果:各組患者在年齡、性別、高血壓病、血糖、血脂、吸煙史等因素間比較均無統(tǒng)計學意義(P0.05);UA組和AMI組患者的PAPP-A、IL-6、hs-CRP、sCD40L和BNP的濃度明顯高于對照組(P0.05);UA組患者的hs-CRP和BNP濃度明顯低于AMI組,UA組與AMI組患者的PAPP-A、IL-6和sCD40L濃度沒有差異(P0.05)。ACS患者的PAPP-A水平與hs-CRP以及BNP呈正相關(P0.05),但是與IL-6和sCD40L無相關性(P0.05)。結(jié)論:1.在急性冠脈綜合征患者血液中PAPP-A、IL-6、hs-CRP、sCD40L和BNP水平顯著升高;2.不穩(wěn)定性心絞痛患者血液中hs-CRP和BNP水平顯著低于急性心肌梗死患者,不穩(wěn)定性心絞痛患者和急性心肌梗死患者血液中PAPP-A、IL-6和sCD40L水平?jīng)]有明顯差異;3.急性冠脈綜合征患者的PAPP-A濃度與hs-CRP和BNP呈正相關,但是與IL-6和sCD40L無相關性。
[Abstract]:Objective: acute coronary syndrome (acute coronary) is a serious disease that endangers human health. In recent years, it has been found that inflammation plays an important role in the development of atherosclerotic plaques. Among them, the pregnancy associated plasma protein A (pregnancy associated plasma protein Agna PAPP A is one of the hot research topics at present. PAPP-A, interleukin-6 (IL-6), plasma Gao Min C-reactive protein (high sensitivity C reactive protein hs-CRP, soluble leukocyte differentiation antigen 40 ligand (soluble CD40 ligand CD40L) and B-type natriuretic peptide (brain natriuretic peptideBNP were detected in patients with ACS. To investigate the clinical value of PAPP-A in acute coronary syndrome and its correlation with hs-CRPsCD40LNP-BNP and IL-6. Method 1: 1. From December 2015 to June 2016, 169 patients were diagnosed as ACS in Department of Cardiology, first affiliated Hospital of Bengbu Medical College, including 116 male patients and 53 female patients. They were divided into (acute myocardial infarction group and unstable angina pectoris group. In addition, 60 healthy people were selected as the control group from the physical examination population. 2. All the patients were in the early hours of the next day after admission. The patients collected venous blood on an empty stomach in the morning of the physical examination. The plasma was separated by anticoagulation and centrifuged to be stored at -70 鈩，

本文編號：2127240