脂蛋白(a)水平与急性心肌梗死患者心功能的关系探讨

Discussion of relationship between lipoprotein(a) level with heart function in patient with acute myocardial infarction

目的探讨脂蛋白(a)[Lp(a)]水平与急性心肌梗死(AMI)患者心功能的关系。方法选取AMI患者120例,根据其血清Lp(a)水平分成3组:A组40例,Lp(a)<138mg/L;B组40例,Lp(a)138～306mg/L;C组40例,Lp(a)>306mg/L。比较各组Lp(a)、左室射血分数(LVEF)水平及Killip≥Ⅲ级患者的比率。结果 A、B组Lp(a)水平低于C组,且A组低于B组,差异均有统计学意义(P<0.01);A、B组LVEF水平高于C组,且A组高于B组,差异均有统计学意义(P<0.01);A、B组Killip≥Ⅲ级者比率低于C组,且A组低于B组,差异均有统计学意义(P<0.01)。Lp(a)水平升高,LVEF下降,两者呈线性相关(r=-0.76,P<0.05);随着Lp(a)水平的升高,Killip≥Ⅲ级患者的发病率显著增高。结论 Lp(a)与AMI患者心功能有关,Lp(a)越高,LVEF越低,心功能越差,高Killip分级的患者比率越高。

Objective To discuss the relationship between lipoprotein （a） [ Lp （a） ] level with heart function in patient with acute myocardial infarction （AMI）. Methods Selected 120 cases of patients with AMI, by serum Lp （a） levels, were divided into three groups：A group（40 cases） ,Lp（a） 〈 138mg/L;B group（40 cases） ,Lp（a） 138 -306mg/L;C group（40 ca- ses ） , Lp （a） 〉 306mg/L. Compared Lp（a） ,left ventricular ejection fraction （LVEF） and the ratio of patient with KiUip 1〉 Ill of each groups. Results The Lp（a） level of A,B group were lower than that of C group,and A group was lower than that of B group,the difference were statistically signifieance（P 〈0.01 ） ;LVEF level of A,B group were higher than of C group,and A group was higher than that of B group, the difference had statistical significance （P 〈 0.01 ） ;The ratio of patient with Killip ≥Ⅲ of A, B group were lower than that of C group, and A group was lower than that of B group ,the difference were statistically significant （ P 〈 0. 01 ）. Lp （a） level rised, LVEF decreased, both showed a linear correlation （ r = - 0.76, P 〈 0. 05 ） ; Along with rising of Lp（a） level, the incidence rate of patient with Killip t≥ Ⅲ was significantly rised. Conclusion Cardiac function of patient with AMI is relat to Lp （a）, Lp （a） higher, LVEF lower, heart function poorer, the ratio of patient with Killip ≥ 19 higher.