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目的:探讨行经皮冠状动脉介入(PCI)治疗的不稳定性心绞痛患者术前血浆妊娠相关血浆蛋白A(PAPP-A)水平对术后高敏C反应蛋白(hs-CRP)和肌钙蛋白(CTnI)的影响。方法:155例择期行经皮冠状动脉介入治疗的不稳定心绞痛患者,根据手术前24hPAPP-A是否升高(PAPP-A≥10mIU/L)分为高PAPP-A组(57例,PAPP-A≥10mIU/L)和低PAPP组(98例,PAPP-A<10mIU/L)。分别检测术后24h内hs-CRP水平及cTnI阳性率,并进行两组间各观察指标的比较。结果:高PAPP-A组术后hs-CRP水平及cTnI阳性率均明显高于低PAPP-A组(P<0.05)。术前PAPP-A含量与术后hs-CRP水平呈显著正相关。Logistic回归分析表明术前血浆PAPP-A水平是术后cTnI阳性的独立预测指标(P<0.05)。结论:冠状动脉介入治疗术前血PAPP-A含量与术后hs-CRP成正相关,是术后炎症反应及心肌损伤的独立预测因素。
Objective: To investigate the effect of preoperative plasma level of plasma protein A (PAPP-A) on the expression of hs-CRP and CTnI in patients with unstable angina undergoing percutaneous coronary intervention (PCI) )Impact. Methods: A total of 155 patients with unstable angina who underwent percutaneous coronary intervention undergoing percutaneous coronary intervention were divided into high PAPP-A group (57 cases, PAPP-A≥1) according to whether PAPAP-A was elevated (PAPP-A≥10mIU / 10mIU / L) and low PAPP group (98 cases, PAPP-A <10mIU / L). The levels of hs-CRP and the positive rate of cTnI in 24h after operation were respectively detected, and the comparison of the observation indexes between the two groups was made. Results: The hs-CRP level and cTnI positive rate in high PAPP-A group were significantly higher than those in low PAPP-A group (P <0.05). Preoperative PAPP-A content and postoperative hs-CRP levels were significantly correlated. Logistic regression analysis showed that preoperative plasma PAPP-A level was an independent predictor of cTnI positivity (P <0.05). CONCLUSION: The preoperative PAPP-A level in patients with coronary artery intervention is positively correlated with postoperative hs-CRP, which is an independent predictor of postoperative inflammatory response and myocardial injury.