血浆脂蛋白a与冠状动脉粥样硬化病变程度相关性研究

Correlation between lipoprotein(a) serum level and coronary atherosclerosis severity

目的研究血浆脂蛋白a[Lp(a)]水平与冠状动脉粥样硬化性心脏病(CHD)及其严重程度的关系。方法回顾性分析因胸痛住院行冠状动脉造影患者469例,检测血浆Lp(a)水平,采用2种分组方法,根据Lp(a)水平四分位分为4组Lp(a)<87 mg/L(116例),87 mg/L≤Lp(a)<158 mg/L(117例),158 mg/L≤Lp(a)<309.5 mg/L(119例),Lp(a)≥309.5 mg/L(117例),根据冠状动脉狭窄程度分为狭窄程度≥50%组(冠心病组)、0<狭窄程度<50%组及无狭窄对照组。依据患者冠状动脉造影结果计算出冠状动脉Gensini评分。结果性别、年龄、高血压病史、糖尿病病史及血浆Lp(a)水平与冠状动脉Gensini评分有关联;Gensini评分随血浆Lp(a)水平升高而升高(P<0.01);冠心病组患者血浆Lp(a)水平明显高于非冠心病组(P<0.01)。结论:血浆Lp(a)水平与冠心病及其严重程度明显相关,对冠心病的诊断、病情评估有一定的临床意义。

Objective To investigate the correlation between Lp(a) serum level and coronaryheart disease(CHD as well as its severity. Methods The clinical data of 469 patients underwent angiography after admission owing to chest pain was retrospectively analyzed. The Lp(a) serum levels were examined, and two grouping methods were used.According to the quartile of Lp(a) serum levels, the patients were divided into four groups with Lp(a)<87 mg/L( n=116), 87 mg/L≤Lp(a)<158 mg/L(n=117), 158 mg/L≤Lp(a)<309.5 mg/L(n=119), and Lp(a)≥309.5 mg/L(n=117). According to the coronary atherosclerosis severity, the patients were divided into the stenosis degree ≥50% group(CHD group), 0<stenosis degree<50% group, and control group without stenosis. The Gensini score was calculated based on the findings of coronary angiography. Results The Gensini score was associated with gender, age, history of hypertension, history of diabetes, and Lp(a) serum level. It increased along with the increasing Lp(a) serum level( P<0.01).Conclusion Lp(a) serum level is significantly correlated with CHD and its severity and may be clinically significant in the diagnosis and evaluation of CHD.