老年患者血浆脂蛋白(a)水平与冠心病的关系研究

Association between plasma lipoprotein(a) level and severity of coronary artery disease

目的探讨中国老年人群血浆脂蛋白(a)水平与冠状动脉硬化程度的关系。方法回顾性分析308例行选择性冠状动脉造影的老年患者的病例资料,将男女患者分别按冠状动脉病变支数及狭窄程度分组,比较各组血浆脂蛋白(a)水平的差异并分析其与冠状动脉病变程度的相关性。结果无论男性还是女性,冠状动脉病变支数越多,血浆脂蛋白(a)水平也越高,以多支病变组升高最明显,分别高于其他各组(P<0.01);随着冠状动脉狭窄程度加重,血浆脂蛋白(a)水平逐渐升高,并与之呈正相关(P<0.01)。不同性别间各亚组血浆脂蛋白(a)比较无统计学差异(P>0.05)。Logistic回归分析显示血浆脂蛋白(a)水平与冠心病发病有关。结论中国老年人群中无论男性或女性,血浆脂蛋白(a)升高与冠状动脉硬化范围及严重程度均呈正相关,是冠心病的一个独立的危险因子,可作为冠心病风险评估的一项指标。

Objective To study the possible association between plasma lipoprotein（a） [ Lp（a） ] level and severity of coronary arteriosclerosis in Chinese elderly patients. Methods 308 old patients undergoing selecting coronary angiography were enrolled in this study. The old patients were classified according to gender and the numbers and extents of coro- nary artery with stenosis. The difference of the level of Lp（a） between female and male was analyzed. The possible correlation between plasma Lp（a） level and coronary stenosis score was studied. Results The plasma Lp （a） level increased with the numbers or extents of coronary stenosis in both female and male. Plasma Lp（a） level was the highest in the three- vessel group and the fourth group. There were significant difference in Lp（a） among groups with different degree of stenosis （ P 〈0. 01 ）. The level of Lp（a） was positively related with the severity of coronary heart disease. Conclusions In both female and male of Chinese, a positive correlation exists between plasma Lp（a） level and the severity of coronary atherosclerosis. Plasma Lp（a） is an independent risk factor and may become a marker to assess the risk of coronary artery disease.