血清脂蛋白-a水平与急性主动脉夹层瘤关联的研究

Association of Lipoprotein(a) concentrations and patients with aortic dissection

目的 探讨脂蛋白 a与主动脉夹层瘤的关系。方法 以诊断明确的 2 7例急性主动脉夹层瘤患者为研究对象 ,以同期年龄、性别构成相近的急性心肌梗死患者 6 0例、健康人群 5 0例为对照 ,分析他们的血脂蛋白 a[LP(a) ]、C 反应蛋白 (CRP)及白细胞 (WBC)计数水平 ,并比较。观察其中 8例主动脉夹层瘤患者发病后 2 4、72h、5dLP(a)、CRP、白细胞计数的动态变化。结果 ①主动脉夹层瘤组、急性心肌梗死对照组、健康对照组血清平均LP(a)浓度分别为 (32 7.35± 89.2 3)、(2 6 1.35± 77.5 4 )、(79.6 9±2 1.6 3)mg L ,3组间差别均有统计学意义 (P <0 .0 5 ) ;②主动脉夹层瘤组和急性心肌梗死对照组患者血平均CRP水平分别为 (12 .12± 6 .15 )、(10 .31± 8.33)mg dl,白细胞计数分别为 (11.0 6± 4 .2 )× 10 9 L、(10 .38± 5 .6 )× 10 9 L ,均高于健康对照组 (P <0 .0 1) ;但前两组患者间CRP、白细胞计数比较无统计学意义 (P >0 .0 5 ) ;③主动脉夹层瘤发病后 72h内LP(a)、CRP水平和白细胞水平均呈持续性升高 ,入院后第5天CRP、白细胞水平明显下降 ,LP(a)仍处于较高水平。结论 急性主动脉夹层瘤患者血清LP(a)水平明显升高 。

Objective To investigate the association of Lipoprotein(a) concentrations and patients with aortic dissection.Methods 27 pateints with aortic dissection were studied. Sixty age-matched and gender-matched patients with acute myocardial infarction and fifty normal subjects were served as control groups. The levels of Serum lipoprotein(a), plasm C-reactive protein, white blood cell count were compared between the three groups. Observed the changes of the levels of lipoprotein(a), C-reactive protein, white blood cell count 24 hours, 72 hours and 5 days after the initial of disease in eight of the patients with aortic dissection. Results 1. Median serum lipoprotein(a) levels of patients with aortic dissection, acute myocardial infarction and normal subjects were 327.35±89.23, 261.35±77.54, 79.69±21.63 mg/L respectively (P<0.05). 2. Median plasma C-reactive protein levels of patients with aortic dissection, acute myocardial infarction were 12.12±6.15, 10.31±8.33 mg/dL respectively, Median white blood cell count of patients with aortic dissection, acute myocardial infarction were (11.06±4.2)×10 9, (10.38±5.6)×10 9/L respectively. They are significantly higher compared with normal control subjects(P<0.01); No significant differences of C-reactive protein concentration and white blood cell count between patients with aortic dissection and acute myocardial infarction. 3. The plasma C-reactive protein concentraion and white blood cell count were stable increasing until 72 hours after the initial of aortic dissection. Serum lipoprotein(a) concentration was still increasing within 5 days after the initial of aortic dissection. Conclusions The lipoprotein(a) serum level is significantly elevated in patients with aortic dissection. Maybe it was because of the inflammation reaction in aortic dissection.