冠心病患者脂蛋白a与纤维蛋白原及Gensini积分的相关性

Relationship of fibrinogen and Gensini score with Lipoprotein(a) in patients with coronary heart disease

目的:探讨冠心病患者体内血浆脂蛋白a[LP(a)]水平与纤溶系统及冠状动脉(冠脉)血管病变程度的关系。方法:入选行冠脉造影确诊的冠心病住院患者128例(冠心病组),非冠心病57例(对照组)。收集两组患者生化指标及冠脉造影结果,采用Pearson相关分析检测LP(a)与纤维蛋白原(Fg)及Gensini积分的关系。结果:①冠心病组LP(a)、血浆Fg、D-二聚体及外周血白细胞水平显著高于对照组(均P<0.05);②血浆LP(a)及Fg水平在3支病变组显著高于单支病变组(均P<0.05),白细胞水平在双支病变组显著高于单支病变组(P<0.05);③LP(a)水平在严重病变组(Gensini积分>30)明显高于轻度病变组(Gensini积分≤30)(P<0.05);④Pearson相关分析显示LP(a)与Fg和Gensini积分均相关(r值分别为0.257和0.211,均P<0.05)。结论:LP(a)与冠脉病变的严重程度关系密切,可能通过纤溶系统参与冠心病的发生、发展。

Objective：To investigate the correlations of fibrinolytic system and the severity of coronary artery lesions with lipoprotein（a） in patients with coronary heart disease （CHD）. Methods：One hundred and twenty-eight hospitalized patients underwent coronary angiography （CAG） were enrolled as CHD group, and 57 subjects with- out CHD as control group. Biochemical latoratory data and results of CAG were collected. Relationships among Fibrinogen, Gensini score and I.ipoprotein（a） were determined by Pearson correlation analysis. Results： （1）Corn pared to control group, serum Lipoprotein （a）, fibrinogen, D-Dimer and leukocyte count were significantly increased in CHD group （all P〈0. 05）. @3-vessel group had significantly higher levels of Lipoprotein（a） and [ihrinogen compared with 1 vessel group （all P〈0.05）. Serum leukocyte in 2-vessel group was higher than that in 1 vessel group （P〈0.05）. （3）Compared to mild CHD （C-ensini score ≤30） group, plasma levels of Lipoprotein （a） in severe CHD （Gensini score 〉30） group was significantly higher （P〈0.05）.（4）Pearson correlation analysis showed that fibrinogen （r=0. 257, P〈0.05） and Gensini score （r=0. 211, P〈0.05） were significantly correla ted with Lipoprotein（a）. Conclusion： Lipoprotein（a） is correlated to the severity of coronary artery lesions in patients with CHD, and may participate in the pathogenesis of CHD by regulating fibrinolytic system.