他汀类药物增加低分子量载脂蛋白(a)表型与维吾尔族冠心病患者脂蛋白(a)水平的研究

Study of statins increasing lipoprotein(a)levels in Uyghur coronary heart disease patients with low molecular weight apolipoprotein A phenotype

目的研究他汀类药物治疗对维吾尔族冠心病(CAD)患者脂蛋白a[Lp(a)]水平的影响。方法选取2019年1月至2022年1月于新疆医科大学第一附属医院心脏中心就诊,住院首次行经皮冠状动脉介入术(PCI)并确诊为冠心病的维吾尔族患者285例。荧光定量PCR方法进行LPA基因KIV-2重复序列数(KIV-2 repeats)检测,根据拷贝数结果将KIV-2 repeats<23作为低分子量(LMW)载脂蛋白A[Apo(a)]表型组(55例),KIV-2 repeats≥23作为高分子量(HMW)载脂蛋白A[Apo(a)]表型组(230例)。两组患者均使用中等剂量他汀类药物稳定治疗3个月,观察中等剂量他汀类药物治疗后,维吾尔族冠心病患者血浆中Lp(a)变化水平是否与Apo(a)表型相关。结果他汀类药物治疗后,Lp(a)水平在总体患者中无明显升高[281.95(134.32,583.08)mg/L至282.61(121.25,607.41)mg/L,P=0.851]。在LMW Apo(a)表型的患者中,Lp(a)水平升高约20.74%,从523.05(356.00,718.70)mg/L显著增加至632.18(429.28,868.20)mg/L(P=0.001),但在具有HMW Apo(a)表型特征的患者中Lp(a)水平变化无统计学差异。结论维吾尔族冠心病患者使用他汀类药物时Lp(a)水平会受Apo(a)表型的影响,他汀类药物增加了LMWApo(a)表型的维吾尔族冠心病患者的Lp(a)水平。

Objective To study the effect of statins on lipoprotein(a)[Lp(a)]levels in Uyghur patients with coronary artery disease(CAD).Methods A total of 285 Uyghur patients who were admitted for the first time for percutaneous coronary intervention(PCI)and were identified as having coronary artery disease were collected,in the Department of Cardiology at the First Affiliated Hospital of Xinjiang Medical University from January 2019 to January 2022.KIV-2 repeat sequences(KIV-2 repeats)of the LPA gene were detected by fluorescence quantitative PCR method;based on the copy number results,KIV-2 repeats<23 were regarded as the low molecular weight(LMW)apolipoprotein A[Apo(a)]phenotype group(55 cases),and KIV-2 repeats≥23 were regarded as the high molecular weight(HMW)apolipoprotein A[Apo(a)]phenotype group(230 patients).Both groups were treated with moderate-dose statins for three months,and it was determined if the level of Lp(a)alterations in plasma of the patients was related with the Apo(a)phenotype.Results The overall patient population’s Lp(a)levels did not significantly increase after statin medication[281.95(134.32,583.08)mg/L to 282.61(121.25,607.41)mg/L;P=0.851].In the LMW Apo(a)phenotype group,the level of Lp(a)increased by about 20.74%,from 523.05(356.00,718.70)mg/L to 632.18(429.28,868.20)mg/L(P=0.001).However,there was no significant difference in the level of Lp(a)in the HMW Apo(a)phenotype group.Conclusion Lp(a)levels in Uyghur patients with coronary artery disease treated with statins are influenced by the Apo(a)phenotype,and statins enhanced Lp(a)levels in Uyghur patients with coronary artery disease who had the LMW Apo(a)phenotype.