中华老年心脑血管病杂志
中華老年心腦血管病雜誌
중화노년심뇌혈관병잡지
Chinese Journal of Geriatric Heart Brain and Vessel Diseases
2015年
11期
1151-1154
,共4页
吴凡%张蔷%杜鑫%张宜青%万征
吳凡%張薔%杜鑫%張宜青%萬徵
오범%장장%두흠%장의청%만정
妊娠相关血浆蛋白A%急性冠状动脉综合征%ROC曲线%危险因素%预后
妊娠相關血漿蛋白A%急性冠狀動脈綜閤徵%ROC麯線%危險因素%預後
임신상관혈장단백A%급성관상동맥종합정%ROC곡선%위험인소%예후
pregnancy-associated plasma protein-A%acute coronary syndrome%ROC curve%risk fac-tors%prognosis
目的：评价妊娠相关蛋白A（PAPP‐A）对预测老年非ST段抬高急性冠状动脉综合征（NSTEACS）患者的预后临床价值。方法选择老年 NSTEACS 患者455例，测定外周血 PAPP‐A 水平，将患者分为高值组147例（PAPP‐A≥23．5 mU／L）和低值组308例（PAPP‐A ＜23．5 mU／L ），随访观察12个月不良心血管事件。分析PAPP‐A水平与不良心血管事件关系。结果随访12个月时，高值组复合终点事件发生率高于低值组（57．7％ vs 24．4％，P＝0．000）。PAPP‐A 界值23．5 mU／L 时，预测不良心血管事件敏感性为66．7％，特异性为75．0％。PAPP‐A升高与不良预后显著相关（OR＝2．832，P＝0．006）；PAPP‐A 升高为评估不良预后的独立危险因素（HR＝2．79，P＝0．007）。结论 PAPP‐A是评价老年NSTEACS患者预后的有效指标，PAPP‐A水平升高预示未来不良心血管事件发生的风险增加，可能有助于对患者进行危险分层。
目的：評價妊娠相關蛋白A（PAPP‐A）對預測老年非ST段抬高急性冠狀動脈綜閤徵（NSTEACS）患者的預後臨床價值。方法選擇老年 NSTEACS 患者455例，測定外週血 PAPP‐A 水平，將患者分為高值組147例（PAPP‐A≥23．5 mU／L）和低值組308例（PAPP‐A ＜23．5 mU／L ），隨訪觀察12箇月不良心血管事件。分析PAPP‐A水平與不良心血管事件關繫。結果隨訪12箇月時，高值組複閤終點事件髮生率高于低值組（57．7％ vs 24．4％，P＝0．000）。PAPP‐A 界值23．5 mU／L 時，預測不良心血管事件敏感性為66．7％，特異性為75．0％。PAPP‐A升高與不良預後顯著相關（OR＝2．832，P＝0．006）；PAPP‐A 升高為評估不良預後的獨立危險因素（HR＝2．79，P＝0．007）。結論 PAPP‐A是評價老年NSTEACS患者預後的有效指標，PAPP‐A水平升高預示未來不良心血管事件髮生的風險增加，可能有助于對患者進行危險分層。
목적：평개임신상관단백A（PAPP‐A）대예측노년비ST단태고급성관상동맥종합정（NSTEACS）환자적예후림상개치。방법선택노년 NSTEACS 환자455례，측정외주혈 PAPP‐A 수평，장환자분위고치조147례（PAPP‐A≥23．5 mU／L）화저치조308례（PAPP‐A ＜23．5 mU／L ），수방관찰12개월불양심혈관사건。분석PAPP‐A수평여불양심혈관사건관계。결과수방12개월시，고치조복합종점사건발생솔고우저치조（57．7％ vs 24．4％，P＝0．000）。PAPP‐A 계치23．5 mU／L 시，예측불양심혈관사건민감성위66．7％，특이성위75．0％。PAPP‐A승고여불량예후현저상관（OR＝2．832，P＝0．006）；PAPP‐A 승고위평고불량예후적독립위험인소（HR＝2．79，P＝0．007）。결론 PAPP‐A시평개노년NSTEACS환자예후적유효지표，PAPP‐A수평승고예시미래불양심혈관사건발생적풍험증가，가능유조우대환자진행위험분층。
Objective To study the prognostic value of pregnancy‐associated plasma protein‐A (PAPP‐A ) in elderly patients with NSTEACS .Methods Four hundred and fifty‐five elderly NSTEACS patients were included in this study .Their serum PAPP‐A level was measured .The patients were followed up for 12 months ,during which the adverse cardiovascular events were ob‐served .The patients were divided into high PAPP‐A group (n=147)and low PAPP‐A group (n=308) .The association between serum PAPP‐A level and adverse cardiovascular events was ana‐lyzed .Results At the end of 12 months follow‐up ,the incidence of combined endpoint events was significantly higher in high PAPP‐A group than in low PAPP‐A group (57 .7% vs 24 .4% ,P=0.000) .The sensitivity and specificity of PAPP‐A were 66 .7% and 75.0% for predicting adverse cardiovascular events when it was 23 .5 mU/L .The elevated PAPP‐A level was significantly asso‐ciated with adverse cardiovascular events (OR= 2 .832 ,P=0.006) .The elevated PAPP‐A level was an independent risk factor for poor prognosis (HR=2 .79 ,P=0 .007) .Conclusion PAPP‐A is an effective indicator of prognosis in elderly NSTEACS patients and can thus be used in assess‐ment of risk factors for their poor prognosis .
