青年急性心肌梗死患者脂蛋白(a)水平的变化及其意义

The change of lipoprotein(a) concentration and the relationship to the coagulative variables in young patients with acute myocardial infarction

目的:探讨脂蛋白(a)[Lp(a)]水平在青年急性心肌梗死(AMI)患者中的变化及其与凝血指标的关系。方法:对32例青年AMI患者、30例青年冠心病(CHD)患者及36例正常对照者进行冠状动脉(冠脉)造影术,并检测其血中Lp(a)、D-二聚体(D-D)、纤溶酶原活性(Pig)、抗凝血酶原(AT-Ⅲ)及组织纤溶酶原激活物(t-PA)的水平。结果:①AMI组和CHD组Lp(a)明显高于正常对照组[(230±60)和(190±20):(110±20)mg/L,P<0.05],但前两组之间差异无显著性意义(P>0.05);②高Lp(a)血症患者AMI的发生率明显高于血清Lp(a)正常的患者(47％:15％,P<0.01);③AMI组D-D明显高于CHD组和正常对照组(12±5):(4±3)mg/L和(2±1)mg/L,P<0.01);④冠脉多支病变者Lp(a)的水平明显高于单支病变者(P<0.01)。结论:青年AMI患者中存在Lp(a)水平增高,并与D-D水平及冠脉病变支数呈正相关。

Objective:To observe the change of lipoprotein(a) concentrations and its relationship to the coagu-lative variables in young patients with acute myocardial infarction. Methods: Ninty eight young subjects were divided into 3 groups: (1)acute myocardial infarction(AMI) group( n = 32);(2)CHD group(n =30); (3)normal control group(n =36). Their serum lipoprotein (a), d-dimer, Pig, t-PA and AT-Ⅲ were detected by ELISA. Results: (1) Compared to control group, there were significant increase of lipoprotein(a) in AMI and CHD group (230±60)mg/L and (190±20)mg/L v. s. (110±20)mg/L, P <0. 05), but there was not significant change in latter two groups. (2) D-dimer concentrations in AMI group were more significantly increased than those in CHD and control group(12±5) mg/L v. s. (4 ± 3) mg/L and (2±1) mg/L, P <0. 01); (3) Lp(a) concentrations in multi-vessel disease's patients were more significantly increased than those in single vessel disease's patients ( P < 0. 01). Conclusion: The Lp(a) concentrations in the young patients with AMI are incresed, and are positively related to d-dimer concentrations and to the number of damaged corondry arteny.