冠心病患者D二聚体的影响因素探讨

Influence of D-dimer on patients with coronary heart disease

目的 探讨不同类型冠心病患者血浆D二聚体的水平及其影响因素。方法 对 12 4例不同类型的冠心病患者与 2 6例正常人分别采用酶联免疫吸附法测定血浆D二聚体和脂蛋白 (a)的水平 ;酶法测定甘油三酯、总胆固醇和高密度脂蛋白胆固醇的浓度 ,并计算出低密度脂蛋白胆固醇浓度 ;免疫散射比浊法测定载脂蛋白A1和载脂蛋白B浓度 ,同时检测其空腹血糖 ;测量其收缩压、舒张压、体重指数 ,并计算其吸烟指数。结果 D二聚体与甘油三酯、载脂蛋白B和脂蛋白 (a)呈明显正相关关系 (r =0 .393,0 .6 5 0和 0 .5 79,P <0 .0 0 1) ;与总胆固醇、收缩压、舒张压和空腹血糖亦呈正相关关系 (r =0 .2 35 ,0 .2 2 6 ,0 .195和 0 .198,P =0 .0 0 9,0 .0 12 ,0 .0 30和 0 .0 2 6 ) ;与载脂蛋白A1和高密度脂蛋白胆固醇呈负相关 (r =- 0 .4 96 ,- 0 .178,P <0 .0 0 1和P =0 .0 4 7)。结论 多种冠心病危险因子对冠心病患者的D二聚体水平有影响 ,其中载脂蛋白B和脂蛋白 (a)为独立影响D二聚体水平的危险因子。

Objective To explore the factors influencing D-dimer in the patients with various kinds of coronary heart disease(CHD).Methods Plasma D-dimer,serum lipoprotein(a),apolipoprotein A 1(ApoA 1),apolipoprotein B(ApoB),triglyceride(TG),total cholesterol(TC),high-density lipoprotein and low-density lipoprotein concentration of 124 cases with CHD and 26 controls were detected respectively by ELISA,immunoturbidimetry and enzymatic method.Fasting blood glucose(FBG),systolic blood pressure(SBP),diastolic blood pressure(DBP) and body mass index(BMI) were measured in all subjects.Results D-dimer was positively correlated with TG,ApoB,Lp(a) (r=0.393,r=0.650,r=0.579,P<0.01),and with TC,SBP,DBP and FBG(r=0.235,0.226,0.195,0.198; P=0.009,0.012,0.030,0.026),while D-dimer was negatively correlated with ApoA 1 and HDL-C(r=0.496,and r=-0.178,P<0.001 and P=0.047).Conclusion Most of the risk factors of CHD influence D-dimer levels in CHD patients,while ApoB and Lp(a) are the independent risk factors for D-dimer.