脂蛋白(a)对冠心病的致病性研究

The effect of lipoprotein( a) in the pathogenic mechanism of coronary heart disease

目的分析血清脂蛋白(a)[Lp(a)]在冠心病发病中的作用。方法将入选的495例患者以Lp(a)水平300 mg/L为切点,分为冠心病组(270例)、非冠心病组(225例),Lp(a)>300 mg/L组(174例)、Lp(a)≤300 mg/L组(321例),分析Lp(a)在冠心病发病中的作用。结果冠心病组血清Lp(a)均值为(310.09±253.73)mg/L,非冠心病组为(261.41±187.11)mg/L,冠心病组明显高于非冠心病患者,差异有统计学意义(P<0.05);Lp(a)>300 mg/L组冠心病患病率明显高于Lp(a)≤300 mg/L组,差异有统计学意义(P<0.05);多因素Logostic回归分析显示,Lp(a)、LDL-C和Apo B同为冠心病独立危险因素。服用他汀类药物者与未服用他汀类药物者Lp(a)水平差异无统计学意义(P>0.05)。结论 Lp(a)是冠心病的独立危险因素,在冠心病的发病中起着重要的作用。

Objective To analyze the effect of lipoprotein （a） [ LP（a） ] in the pathogenic mechanism of coronary heart disease （CHD）. Methods Four hundred and ninety-five individuals in this study were enrolled and divided into CHD group and non-CHD,and high level of LP（a） （ 〉 300 mg/L） group and low level of LP（a） （ ≤300 mg/L） group,the effect of LP（a） in the pathogenic mechanism of CHD was analyzed. Results Levels of LP（a） was 310.09 ± 253.73 mg/L in CHD group,and 261.41 ±187.11 mg/L in Non-CHD group. Difference in levels of LP（a） between the two groups was significant （P 〈0.05 ）. The incidence rate of CHD in the high level of LP（a） group was significantly higher than that in the low level of LP（a） group （P 〈 0.05）. Logostie regression analysis showed that LP （a）, LDL-C, and ApoB were independent risk factors for CHD. Difference in levels of LP （a） between patients with statin treatment and patients without statin treatment was no significant （P 〉0.05）. Conclusion Lp（a） is an independence risk factor for CHD ,which may play important role in the pathogenic mechanism of CHD.