血脂蛋白a在冠心病早期筛查中的应用研究

The Application of Lipoprotein(a) for Screening Coronary Arteriosclerotic Heart Disease

目的研究应用血脂蛋白a[Lp(a)]对冠心病早期筛查的价值。方法选取在我院拟诊为冠心病并行64排螺旋CT冠状动脉成像(64-muti-slice spiral coronary computed tomography angiography,MSCTA)的患者301例,根据MSCTA结果分为正常组和病变组,再根据冠状动脉病变支数将病变组分为单支病变、双支病变和三支病变三个亚组。同时检测Lp(a)、总胆固醇(CHO)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)等指标。结果 (1)病变组Lp(a)、TC、TG、LDL-C水平均高于对照组(P均<0.05),其HDL-C水平均低于对照组(P均<0.05)。(2)病变亚组两两比较,三支病变组Lp(a)高于单支病变组(P <0.05)。而双支病变组与单支病变、三支病变组之间Lp(a)水平差异无统计学意义(P均> 0.05)。(3)病变亚组两两比较,除Lp(a)外其他指标的差异均无统计学意义(P均> 0.05)。结论临床工作中应重视检测Lp(a),其能更有效地辅助MSCTA早期筛查冠心病高危患者、预测病变严重程度。

Objective To investigate the role of lipoprotein（a） [Lp（a）] forscreening coronary arteriosclerotic heart disease（CAD）. Methods A totalof 301 patients with suspected CAD in our hospital were selected. They alldetected by MSCTA, respectively divided into disease and healthy groupsaccording to the results of MSCTA. Furthermore, the disease group wasdivided into three subgroups single vessel lesion group, double vessellesion group and triple vessel lesion group according to arterioscleroticlesion vessel numbers. Serum Lp（a）, total cholesterol（TC）, triglyceride（TG）,low density lipoprotein cholesterol（LDL-C）, high density lipoproteincholesterol（HDL-C） were measured. Results （1） Lp（a）, TC, TG, LDL-Cofdisease subgroup were higher than those in healthy group（P 〈 0.05）, andHDL-C was lower than that in the healthy group（P 〈 0.05）.（2） Comparingof each subgroup in the disease group, Lp（a） of triple vessel lesiongroup was higher than that in single vessel lesion group（P 〈 0.05）. Whencompared with Lp（a） of double vessel lesion group, Lp（a） of single andtriple vessel lesion group showed no statistically significant difference（P 〉0.05）. （3） Comparing of each subgroup in the disease group, there were nosignificant difference in other indexes except Lp（a）（P 〉 0.05）. ConclusionWe should pay attention to detect serum Lp（a）. Lp（a） can effectively assistMSCTA for screen high-risk patients with CAD more early and predict theseverity of the disease.