急性心肌梗死患者脂蛋白(a)与纤维蛋白原及冠脉病变的关系探讨

The Relationship between Lipoprotein(a) and Fibrinogen and Severity of Coronary Artery Atherosclerosis in Acute Myocardial Infarction

目的探讨急性心肌梗死(AMI)患者血浆脂蛋白(a)[Lp(a)]与纤维蛋白原(Fig)及冠脉病变的相关关系。方法102例AMI患者检测血脂和Fig,并行冠脉造影检查,按血浆Lp(a)浓度分为高Lp(a)组(≥300mg/L)和低Lp(a)组(<300mg/L),比较两组血浆Fig及冠脉病变特点的差异。结果Lp(a)与Fig、冠脉狭窄分数、有明显相关性(P<0.01)。高Lp(a)组的Fig水平、冠脉狭窄分数、梗死相关血管的残余狭窄程度、血管闭塞率均明显高于低Lp(a)组(P<0.05),其心肌梗死溶栓治疗试验(TIMI)血流评分明显低于低Lp(a)组(P<0.05)。结论血浆Lp(a)升高的AMI患者,其Fig水平也异常升高,冠状动脉狭窄分数增加,IRA的残余狭窄程度加重,血流速度缓慢,血管闭塞率增加。

Objective To investigate the relation between lipoprotein （a） [Lp（a）] and plasma fibrinogen and coronary artery lesion in patients （pts） with acute myocardial infarction （AMI）. Methods One hundred and two pts with AMI were studied and coronary angiography were performed in all pts. Serum lipid and fibrinogen were measured. The results were compared between the low Lp（a） group （〈300 mg/L） and the high Lp（a） group （≥300 mg/L）. Results Plasma concentration of Lp（a） was correlated with plasma fibrinogen and coronary artery athcrosclerosis. The severity of coronary artery atherosclerosis and the residual stenosis of the infarct - related artery in the high Lp（a） group were more than that in low Lp（a） group （P〈〈0.05）. Antegrade TIMI flow in the infarct-related artery was lower in the high Lp（a） group （P〈0.05）. There were more occluded IRAS greater in pts with high Lp（a） levels （P〈0. 05）. Conclusion Pts with high Lp（a） levels had higher plasma fibrinogen concentration. Elevated Lp（a） levels could affect the residual stenosis,antegrade TIMI flow, the number of occluded IRA and the severity of coronary artery atherosclerosis in AMI pts.