基于冠状动脉CTA研究冠状动脉斑块成分与血清Lp(a)水平的相关性

To Explore the Correlation between Coronary Artery Plaque Components and Serum Lp(a) Levels by Using CTA Technique

目的 通过对参与本研究患者的冠状动脉CT血管造影(CTA)图像进行观察分析,探讨冠状动脉粥样硬化斑块的成分及发生率与血清脂蛋白(a)[Lp(a)]水平的潜在性关系。方法 选取华北理工大学附属医院2017年10月至2019年8月,共188例疑似为冠心病且血清Lp(a)增高的患者且作为观察组;选取188例同时期疑似为冠心病且血清Lp(a)正常的患者作为对照组。观察统计并处理分析两组患者冠状动脉主要分支粥样硬化斑块发生率、病变血管段数及不同性质斑块构成比等方面的具体情况。结果 观察组与对照组粥样硬化斑块的发生率为76.6%、66.5%,两组结果具备统计学差异(P<0.05);观察组与对照组病变血管的段数占比为11.5%、5.0%,两组结果具备统计学差异(P<0.05);观察组与对照组不同性质斑块构成比间具备统计学差异(P<0.05)。观察组与对照组冠状动脉三大分支中各支不同斑块性质的构成比间均具备统计学差异(P<0.05)。但观察组与对照组左主干不同斑块性质的构成比间不具备统计学差异(P=0.09>0.05);且观察组三大主支中各支不同斑块性质的构成比不具备统计学差异(P>0.05)。结论 冠状动脉粥样硬化斑块的成分及发生率与血清Lp(a)水平存在一定相关性,通过监测患者血清中Lp(a)水平的变化,可一定程度上预测冠状动脉粥样硬化斑块的成分及发生率,有一定的临床指导意义。

Objective To investigate the potential relationship between the composition and incidence of coronary ath-erosclerotic plaque and serum Lp(a) level by observing and analyzing coronary ARTERY CTA images of patients participat-ing in this study.Methods A total of 188 patients with suspected coronary heart disease and elevated serum Lp(a) wereselected from the Affiliated Hospital of North China University of Science and Technology from October 2017 to August 2019 as the observation group.A total of 188 patients with suspected coronary heart disease and normal serum Lp(a) were select-ed as the control group.The incidence of atherosclerotic plaque in the main branches of coronary arteries,the number of dis-eased vascular segments and the composition ratio of plaques with different properties were observed and analyzed.Results The incidence of atherosclerotic plaque in the observation group versus the control group was 76.6% vs.66.5%,andthere was a statistical difference between the two groups(P< 0.05).The proportion of pathological vascular segments in theobservation group versus the control group was 11.5% vs.5.0%,and there was a statistical difference between the twogroups(P< 0.05).There was a statistical difference between the observation group and the control group in the proportionof plaque composition with different properties(P< 0.05).There were statistically significant differences in the proportionsof different plaque properties in the three branches of coronary arteries in the observation group versus the control group(P< 0.05).However,there was no significant difference in the proportions of different plaque properties between the observa-tion group and the control group(P= 0.09 > 0.05).In addition,there was no statistical difference in the component ratio ofdifferent plaque properties among the three main branches in the observation group(P> 0.05).Conclusion The compo-sition and incidence of coronary atherosclerotic plaque are correlated with the level of serum Lp(a).Monitoring the changeof serum Lp(a) can predict the composition and incidence of coronary atherosclerotic plaque to a certain extent,which hascertain clinical guiding significance.