血浆脂蛋白a与老年钙化性主动脉瓣膜病的关系

Relationship between plasma lipoprotein a and senile calcified aortic valve disease

目的探讨血浆脂蛋白a水平与老年钙化性主动脉瓣膜病的关系。方法选择2015年1月至2017年12月于华北理工大学附属医院内科住院的年龄在60岁以上的钙化性主动脉瓣膜疾病(CAVD)患者343例作为病例组,选取同期住院的年龄、性别、吸烟史、饮酒史相匹配,同时心脏超声提示无主动脉瓣膜钙化的患者343例为对照组。对两组患者一般资料进行收集整理,对比分析两组的性别、年龄、吸烟史、糖尿病史、高血压病史、血清总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、尿酸(UA)、血钙(Ca)、血磷(P)、血浆脂蛋白a[Lp(a)],将病例组分为硬化组和狭窄组,计数资料两组间比较采用χ2检验,计量资料两组间比较采用独立样本t检验,应用二元Logistic回归分析危险因素同CAVD的关系。结果①病例组血浆脂蛋白a、高血压病史与对照组相比差异有统计学意义(P<0.05),吸烟史、饮酒史、HDL-L、TC、TG等相比差异无统计学意义(P>0.05);②二元Logistic回归分析显示脂蛋白与CAVD之间存在显著相关性(P<0.001),高血压病史存在相关性(P<0.05),其他血脂TC、TG、LDL-C等未发现相关性;③硬化组与狭窄组脂蛋白a相比差异有统计学意义(P<0.05),硬化组与狭窄组TC、TG、HDL-C、LDL-C等相比差异没有统计学意义(P>0.05)。结论血浆脂蛋白a、高血压是CAVD的独立危险因素。

Objective To discuss the relationship between the level of plasma lipoprotein a[Lp(a)]and senile calcified aortic valve disease(CAVD).Methods CAVD patients aged over 60(n=343,case group)were chosen from Department of Cardiology in Affiliated Hospital of North China University of Science and Technology from Jan.2015 to Dec.2017.The patients(n=343)without CAVD,matched in age,sex and history of smoking and drinking,were chosen into control group at the same term.The general data was collected from patients in 2 groups,and sex,age,history of smoking,diabetes and hypertension,and levels of TC,TG,LDL-C,HDL-C,UA,Ca,P and Lp(a)were compared and analyzed in 2 groups.The case group was divided into atherosclerosis group and stenosis group.The count data was compared by using c2 test,and quantitative data was compared by using independentsample t test.The relationship between risk factors and CAVD was analyzed by using binary Logistic regression.Results①The difference in level of plasma Lp(a)and hypertension history had statistical significance(P<0.05),and difference in history of smoking and drinking,and levels of HDL-L,TC and TG had no statistical significance(P>0.05)between case group and control group.②The results of binary Logistic regression showed that Lp(a)was significantly correlated to CAVD(P<0.001),correlated to hypertension history(P<0.05),and was not correlated to levels of TC,TG and LDL-C.③The difference in Lp(a)had statistical significance(P<0.05),and difference in levels of TC,TG,HDL-C and LDL-C had no statistical significance(P>0.05)between atherosclerosis group and stenosis group.Conclusion Lp(a)and hypertension are independent risk factors of CAVD.