脂蛋白a、胱抑素C与冠状动脉病变严重程度的相关性

The correlation between the levels of lipoprotein( a)and cystatin-C,and severity of coronary artery disease

目的:探讨血脂蛋白a[Lp(a)]、胱抑素C(Cys-C)与冠状动脉病变严重程度的关系。方法:选取疑似冠心病病人,依据冠状动脉造影结果,采用Gensini评分法,将所有病人依冠状动脉病变严重程度分为4组,A组(0分,n=100)、B组(1~30分,n=152)、C组(31~90分,n=48)和D组(≥91分,n=39)。测定所有入选者的空腹血糖(FPG)、三酰甘油(TG)、胆固醇(TC)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、血肌酐(SCr)、尿素氮(BUN)、Lp(a)、Cys-C及同型半胱氨酸,分析Lp(a)、Cys-C与冠状动脉造影Gensini评分相关性。结果:4组间TG、LDL、BUN、SCr差异均无统计学意义(P>0.05)。D组FPG、TC、Cys-C均较A组、B组升高(P<0.05~P<0.01)。C组、D组同型半胱氨酸水平均较A组升高(P<0.05)。随着冠状动脉病变程度的增加,Lp(a)水平逐渐升高(P<0.01)。Cys-C、Lp(a)与Gensini积分均呈正相关关系(P<0.01)。结论:Lp(a)、CysC与冠状动脉严重程度密切相关。

Objective：To explore the correlations between the levels of lipoprotein（ a） [ Lp（ a） ] and cystatin-C（ Cys-C） ,and severity of coronary artery disease（CHD）. Methods：The patients suspected with CHD were divided into the group A（0 point,n=100）,group B（1 to 30 points,n=152）,group C（31 to 90 points,n=48） and group D（≥91 points,n=39） according to the severity of CHD （ using Gensini scoring of coronarography ） . The levels of fasting plasma glucose （ FPG ） , triglycerides （ TG ） , cholesterol （ TC ） , high-density lipoprotein cholesterol（HDL）,low-density lipoprotein cholesterol（LDL）,serum creatinine（SCr）,blood urea nitrogen（BUN）, 4（a）,Cys-C and homocysteine in all patients were detected,the correlations between the levels of Lp（a） and Cys-C,and Gensini scoring of coronarography in four groups were analyzed. Results：The differences of the levels of TG,LDL,BUN and SCr between four groups were not statistically significant（P〉0. 05）. Compared with group A and B,the levels of FPG,TC and Cys-C in group D significantly increased（P〈0. 05 to P〈0. 01）. Compared with group A,the level of Hcy in group C and D was increased（P〈0. 05）. With the increasing of severity of CHD,the level of Lp（a） significantly increased（P〈0. 01）. The levels of Cys-C and Lp（a） were positively correlated with the Gensini score（P〈0. 01）. Conclusions：The levels of serum Lp（a） and Cys-C are closely related to the severity of CHD.