冠心病患者脂蛋白(α)与D-二聚体的变化及其相关性研究

The changes and relationships of lipoprotein(α) and d-dimer in patients with coronary heart disease

目的 观察冠心病 (CHD)患者血清脂蛋白α[Lp(α) ]与血浆D -二聚体 (DD)水平的变化特点 ,并探讨它们之间的关系。方法 对 12 4例CHD患者和 2 6例正常人采用双抗体ELISA法测定Lp(α)浓度和DD水平。结果 CHD患者中 ,急性心肌梗死 (AMI)和不稳定性心绞痛 (UAP)组患者Lp(α)浓度显著高于对照组 (P <0 .0 1) ;陈旧性心肌梗死 (OMI)和稳定性心绞痛 (SAP)组患者Lp(α)浓度亦有一定程度的升高 (P <0 .0 5 )。与对照组相比 ,AMI组患者DD水平显著升高 (P <0 .0 1) ,UAP组患者DD水平亦有所升高 (P <0 .0 5 )。组间比较发现 ,Lp(α)水平在OMI与SAP、UAP与AMI组间差异无显著性 (P >0 .0 5 ) ;DD水平在OMI与SAP组间差异无显著性 (P >0 .0 5 ) ;UAP与AMI组比较有显著差异性 (P <0 .0 5 ) ,后者高于前者 ;UAP、AMI组与SAP、OMI组比较 ,前两组患者DD水平高于后两组 (P <0 .0 5 )。12 4例CHD患者相关分析显示 :Lp(α)与DD水平呈显著正相关 (r=0 .5 79,P <0 .0 0 1)。结论 冠心病患者Lp(α)显著升高且与反映继发性纤溶增强的指标DD有密切相关关系。

Objectives To evaluate the changes of Lipoprotein(α) [Lp(α)] and D-dimer(DD) levels in the subjects with coronary heart disease(CHD),and to explore their relationships.Methods Lp(α) and DD concentration were measured by ELISA. Results Among the patients of CHD,the concentration of Lp (α) in subjects with acute myocardial infarction (AMI) and unstable angina pectoris (UAP)was significantly higher than that of controls(P<0.01);the concentration of Lp(α) in subjects with old myocardial infarction (OMI) and stable angina pectoris (SAP)was also higher than that of controls(P<0.05).Compared with control group,DD levels of OMI and SAP did not change significantly(P>0.05),while UAP or AMI had higher DD levels(P< 0.05 - 0.01 ),and DD levels in the group of AMI were higher than those of UAP(P<0.05). Linear correlation in the 124 patients with CHD showed that Lp (α) correlated positively with DD(r=0.579,P<0.001).Conclusions Higher Lp (α) and DD levels were present in the subjects with CHD Lp (α) played an important role in higher DD levels.