脂蛋白(a)水平与主动脉瓣狭窄及冠状动脉疾病发生风险的相关性研究

Correlation of lipoprotein(a) with the development of aortic valve stenosis or clinical coronary artery disease

目的探讨脂蛋白(a)[Lp(a)]与主动脉瓣狭窄(AVS)及临床冠状动脉疾病(CAD)发生风险的相关性。方法收集2014~2017年于南京医科大学第一附属医院确诊的215例重度AVS病人,另随机匹配了215例无AVS的病人作对照,对其临床资料进行回顾性分析,并对相关危险因素进行Logistic回归分析。结果Lp(a)水平在有无AVS 2组间差异无统计学意义(P>0.05);根据有无临床CAD分层后,Lp(a)在有无AVS 2组间比较差异仍无统计学意义(P>0.05)。而无论是否根据有无AVS分层,CAD组病人的Lp(a)水平均明显高于无CAD组(P<0.05)。Logistic回归分析显示,校正了年龄、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、糖尿病、高血压等因素后,Lp(a)水平与AVS无明显相关性(P>0.05),而与CAD显著相关(P<0.05)。结论在年龄>60岁的人群中,Lp(a)与临床CAD显著相关,是CAD发生的危险因素,但AVS的进展并不受Lp(a)的影响。

Objective To explore the correlation of lipoprotein(a)[Lp(a)]with the development of aortic valve stenosis(AVS)or clinical coronary artery disease(CAD).Methods A total of 215 patients with severe AVS diagnosed in the First Affiliated Hospital of Nanjing Medical University from January 2014 to December 2017 were collected,and another 215 patients without AVS were randomly matched as controls.The clinical data were retrospectively analyzed,and the related risk factors of AVS and CAD were analyzed by Logistic regression.Results Comparing with the patients without AVS,the patients with AVS showed no difference in the level of Lp(a)(P>0.05).In contrast,the patients with clinical CAD manifestation showed higher level of Lp(a)than those without clinical CAD manifestation(P<0.05)regardless of AVS stratification or not.Logistic regression analysis showed no significant association of Lp(a)with AVS in risk factor-adjusted model that included age,low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),diabetes,hypertension and other factors(P>0.05).However,Lp(a)was independently associated with clinical CAD manifestation(P<0.05).Conclusions In a large cohort of patients>60 years,Lp(a)was associated with clinical CAD manifestation,but not with AVS.