血浆脂蛋白(a)与冠状动脉硬化的关系

Correlation between plasma lipoprotein(a)and severity of coronary atherosclerosis

目的:了解血浆脂蛋白(a)[(Lp(a)]与冠状动脉粥样硬化程度之间的关系。方法:选择2010年2月至2011年3月在我院心血管内科住院并行冠状动脉造影术的患者共525例,根据冠脉造影术结果分成冠心病组(266例,主干或分支直径狭窄程度>50%)和正常对照组(259例,主干或分支直径狭窄程度≤50%)。再将狭窄组分为单支组(97例),双支组(97例)和多支(3支或3支以上)组(90例),采用免疫投射比浊法测定患者的Lp(a),并将狭窄组和正常对照组以及狭窄组中不同亚组患者的Lp(a)浓度进行比较,明确Lp(a)浓度与冠脉病变程度的关系。结果:冠心病组患者的Lp(a)浓度明显高于正常对照组[(179.5±23.4)mg/L比(138.8±17.8)mg/L,P<0.01]。在冠心病组中多支组与双支组的Lp(a)水平显著高于单支组[(232.98±43.65)mg/L比(196.31±20.7)mg/L比(142.39±18.00)mg/L,P<0.05];多支组Lp(a)水平显著高于双支组(P<0.05)。偏相关分析显示,Lp(a)水平与冠脉的病变程度呈明显正相关(r=0.579,P<0.05)。结论:Lp(a)水平与冠状动脉粥样硬化程度呈正相关,检测Lp(a)水平有助于对冠心病的诊断,分层及预后判断。

Objective： To study the correlation between plasma level of lipoprotein （a） [ （Lp （a） ] and severity of coro-nary atherosclerosis. Methods：A total of 525 patients, who admitted in our department of cardiology from Feb 2010 to Mar 2011 and were performed coronary angiography（CAG）, were enrolled. According to CAG result, patients were divided into coronary artery disease （CAD）group （n = 266, stenosis of diameter in main or branch was 〉50%） and normal control group （n = 259, stenosis of diameter in main or branch was 450 % ）. Then the stenosis group was further divided into single vessel coronary disease group （n = 79）, double-vessel coronary disease group （n = 97） and multi-vessel coronary disease group （n = 90）. Immune turbidimetry was used to measure Lp （a） level. The Lp（a） concentration was compared among all groups and correlation was analyzed between Lp（a） concentration and severi-ty of coronary disease. Results：Compared with normal control group, there was significant increase in Lp（a） con-centration [（138. 8± 17.8） mg/L vs. （179.5 ± 23.4） mg/L, P〈0.01] in CAD group. In CAD group, compared with single vessel coronary disease group, there was significant increase in Lp （a） level [（142. 39 ± 18. 00） mg/L vs. （196.31 ± 20.7） mg/L vs. （232.98 ± 43.65） mg/L, P〈0.05] in double-and multi-vessel coronary disease group. Lp（a） level in multi-vessel coronary disease group was significantly higher than that of double-vessel coronary disease group, P〈0. 05. Partial correlation analysis indicated that Lp （a） level was positively correlated to severity of coro-nary disease （r = 0. 679, P〈0.05）. Conclusion：Lipoprotein （a） is positively correlated to severity of coronary ather-osclerosis; Lp detection is helpful to diagnosis, stratification and Judgment of prognosis for coronary heart disease.