早发冠心病患者脂蛋白a与临床类型及冠状动脉病变关系的初步研究

Study on the relationship between serum lipoprotein a and clinical types with coronary lesions in the patients with premature coronary heart disease

目的 探讨早发冠心病患者血浆脂蛋白a[Lp(a) ]水平与冠状动脉病变程度及临床类型的关系。方法 采用Judkins法对 12 6例胸痛或胸部不适患者行冠状动脉造影 ,确诊为早发冠心病患者 ,以Lp(a)水平差异分为两个亚组 ,并与 89例对照者进行比较分析。结果 早发冠心病组血浆Lp(a)为 (2 33± 114 )mg/L明显高于对照组 (190± 78)mg/L(P <0 .0 5 ) ;早发冠心病患者Lp(a)低于 30 0mg/L亚组中 ,心肌梗死、不稳定型心绞痛和稳定型心绞痛比例无明显差异 ;而在Lp(a)异常升高亚组 ,临床表现为不稳定型心绞痛的比例最高 (5 4 % ) ,明显高于另两种临床类型 (P <0 .0 5 )。冠状动脉病变高积分组Lp(a)水平明显高于中等积分组和低积分组 (P <0 .0 1或 0 .0 5 )。结论 早发冠心病患者血浆Lp(a)

Objective To explore the relationship between serum lipoprotein a [Lp(a)] and clinical types and coronary lesions in patients with premature coronary heart disease.Methods 126 cases with chest pain or chest discomfort diagnosed as premature coronary heart disease underwent coronary angiography by Judkins,who were divided into two subgroups according to Lp(a) levels and compared with 89 controls.Results Plasma Lp(a) in premature coronary heart disease group was significantly higher than that of control group[(233±114)mg/L vs (190±78)mg/L,P<0.05].There was no difference in the proportion of myocardial infarct,unstable angina pectoris and stable angina pectoris in the subgroup of premature coronary heart disease(Lp (a)<300 mg/L ),but the unstable angina pectoris affected the most(54%) in abnormally elevated Lp(a) subgroup,which proportion was significantly higher than that of the other two subgroups(P<0.05).Lp(a) levels in the higher coronary lesion scores was higher than that of moderate and low coronary lesion scores(P<0.01 or 0.05).Conclusion Lp(a) levels of premature coronary heart disease patients are closely related with its clinical types and coronary lesions.