目的 探讨血浆妊娠相关血浆蛋白A(PAPP-A)、可溶性CD40配体(sCD40L)对急性冠状动脉综合征(ACS)危险分层的临床价值.方法 选取2011年8月至2012年2月该院心内科住院的ACS患者118例,按病情将其分为AMI组36例,UAP组40例,SAP组42例,选择同期冠状动脉造影正常者38例为对照组.比较4组患者电化学发光法检测血浆PAPP-A,酶联免疫吸附试验法检测血浆sCD40L等资料.结果 AMI组和UAP组与SAP组和对照组血浆PAPP-A、sCD40L浓度比较差异有统计学意义(P<0.05),ACS患者血浆PAPP-A和sCD40L存在明显的正相关性(r=0.862,P<0.05).结论 血浆PAPP-A和sCD40L能够反映ACS患者斑块的易损性,与ACS患者危险性密切相关,可作为临床上评价ACS患者危险程度的简单、有效、实用的方法.%Objective To investigate the clinical value of plasma pregnancy associated plasma protein A(PAPP A) and CD40 ligand(sCD40L) on the risk stratification of acute coronary syndrome (ACS). Methods 118 inpatients with ACS in this hospital from August 2011 to February 2012 were selected and divided into the acute myocardial infarction(AMI) group(36 cases) ,the un stable angina pectoris(UAP) group(40 cases). Contemporaneous 38 cases of normal coronary angiography were selected as the con trol group. Plasma PAPP A was detected with electrochemiluminescence and plasma sCD40L was assayed with ELISA. The detec ted results were compared among 4 groups. Results The plasma PAPP A and sCD40L concentrations were statistically different between the AMI and the UAP groups with the SAP group and the control group(P<0. 05). In the ACS group,the plasma PAPP A level was positively correlated with plasma sCD40L level(r=0. 862,P<0. 05). Conclusion Plasma PAPP A and sCD40L can re fleet the plaques vulnerability of ACS patients and are closely related to the risk of ACS patients,which can be used as the simple, effective and practical method for evaluating the risk degree of ACS patient.
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