摘要
目的探讨妊娠相关血浆蛋白-A(PAPP-A)在中国人群不同类型冠心病患者中的水平及意义。方法计算机检索2013年12月前公开发表的中国人群PAPP-A与冠心病关系的病例对照研究文献,检索数据库包括Pub Med、Cochrane图书馆、EMbase、中国知网、万方数据库和维普数据库等。采用Stata 12.0软件进行数据分析。结果研究纳入文献44篇,病例组3 628例,其中稳定性心绞痛(SAP)1 137例,不稳定性心绞痛(UAP)1 368例,急性心肌梗死(AMI)1 123例;对照组1 177例。Meta分析结果表明,SAP组、UAP组、AMI组PAPP-A水平分别与对照组比较,差异均有统计学意义[SMD=0.38,95%CI(0.25,0.50),P<0.001;SMD=2.84,95%CI(2.36,3.32),P<0.001;SMD=3.31,95%CI(2.78,3.85),P<0.001]。AMI组PAPP-A水平与UAP组比较,差异有统计学意义[SMD=0.56,95%CI(0.33,0.80),P<0.001]。1、2、3支冠状动脉病变组PAPP-A水平明显高于对照组[SMD=2.40,95%CI(1.49,3.31),P<0.001;SMD=2.27,95%CI(1.44,3.09),P<0.001;SMD=2.30,95%CI(1.35,3.24),P<0.001]。2支组PAPP-A水平明显高于1支组[SMD=0.29,95%CI(0.01,0.58),P=0.042],但是3支组PAPP-A水平与1、2支比较差异无统计学意义(P>0.05)。结论中国人群冠心病患者PAPP-A水平明显升高,且与冠心病的严重程度相关,测定患者PAPP-A浓度可作为判断冠心病病情严重程度的指标。
Objective To explore the relationship between pregnancy-associated plasma protein-A （PAPP-A） and different types of coronary heart disease （CHD） in Chinese. Methods The papers about the relationship between the PAPP-A level and coronary heart disease in Chinese published before December 2013 were searched from electronic databases, including PubMed, EMbase, China National Knowledge Infrastructure, Wanfang and VIP. Statistical analysis was carried out using Stata 12.0 software. Results A total of 44 papers were included in this meta-analysis. The number of cases was 3 628, including 1 137 stable angina pectoris （SAP） patients, 1 368 unstable angina pectoris （UAP） patients and 1 123 acute myocardial infarction （AMI） patients. The number of control was 1 177. This meta-analysis indicated that the levels of PAPP-A were higher in different types of CHD patients than those in the control group [SAP group： SMD=0.38, 95% CI （0.25, 0.50）, P 〈 0.001; UAP group： SMD=2.84, 95% CI （2.36, 3.32）, P 〈 0.001; AMI group： SMD=3.31, 95% CI （2.78, 3.85）, P 〈 0.001, respectively]. The levels of PAPP-A were higher in AMI group than UAP group [SMD=0.56, 95% CI （0.33, 0.80）,P 〈 0.001]. At the same time, the levels of PAPP-A in patients with disease of one, two and three coronary arteries were higher than those in the control group [SMD=2.40, 95% CI （1.49, 3.31）, P 〈 0.001; SMD=2.27, 95% CI （1.44, 3.09）, P 〈 0.001; SMD=2.30, 95% CI （1.35, 3.24）, P 〈 0.001, respectively]. The levels of PAPP-A were higher in patients with disease of two arteries than in those of one artery [SMD=0.29, 95% CI （0.01,0.58）, P=0.042], but there was no significant difference between patients with disease of three arteries and those of i or 2 arteries（P〈0.05）. Conclusions The levels of PAPP-A are significantly higher in CHD patients and are positively related with the severity of CHD. The levels of PAPP-A can be regarded as the indicator for judging the severity of CHD.
出处
《华西医学》
CAS
2015年第1期6-11,共6页
West China Medical Journal
基金
常州市武进区科技发展项目(WS201317)~~
