血浆脂蛋白a与冠状动脉粥样硬化病变程度相关性研究
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摘要
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
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
引文
[1]蔡东平,贺永明.中国汉族人群血浆脂蛋白(a)浓度与冠心病相关大样本横断面研究[J].门诊杂志,2016,10(1):138-143.
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[4]Gensini GG.A more meaningful scoring system for determining the severity of coronary heart disease letter[J].Am J Cardiac,1983,51:606-611.
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[6]翁建平,陆菊明,贾伟平,等.中国2型糖尿病防治指南(2013年版)[J].中华糖尿病杂志,2014,6(7):447-498.
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[8]Dahlen GH,Guyton JR,Attar M,et al.Association of levels of lipoprotein Lp(a),plasma lipids,and other lipoproteins with coronary artery disease documented by angiography[J].Circulation,1986,74:758-765.
[9]周辉,王岚峰.脂蛋白(a)与急性ST段抬高型心肌梗死患者冠脉病变严重程度相关性研究[J].现代中西医结合杂志,2016,25(25):2761-2763.
[10]Heigl F,Hettich R,Lotz N,et al.Clinical benefit of long-term lipoprotein apheresis in patient with severe hypercholesterolemia or Lp(a)-hyperlipoproteinemia with progressive cardiovascular disease[J].Clin Res Cardiol Suppl,2015,10:33-38.
[2]Angenlin B.Fifty years of lipoprotein(a)-the magical mystery tour continues[J].J Intern Med,2013,273(1):3-5.
[3]Kamstrup PR,Benn M,Tybjaerghansen A,et al.Extreme lipoprotein(a)levels and risk of myocardial infarction in the general population:the Copenhagen City Heart Study[J].Circulation,2008,117(2):176-184.
[4]Gensini GG.A more meaningful scoring system for determining the severity of coronary heart disease letter[J].Am J Cardiac,1983,51:606-611.
[5]王文,姚崇华,朱鼎良,等.中国高血压基层管理指南(2014年修订版)[J].中华健康管理学杂志,2015,9(1):10-30.
[6]翁建平,陆菊明,贾伟平,等.中国2型糖尿病防治指南(2013年版)[J].中华糖尿病杂志,2014,6(7):447-498.
[7]赵水平.赵水平血脂学研修全集[M].长沙:中南大学出版社,2014:67-76.
[8]Dahlen GH,Guyton JR,Attar M,et al.Association of levels of lipoprotein Lp(a),plasma lipids,and other lipoproteins with coronary artery disease documented by angiography[J].Circulation,1986,74:758-765.
[9]周辉,王岚峰.脂蛋白(a)与急性ST段抬高型心肌梗死患者冠脉病变严重程度相关性研究[J].现代中西医结合杂志,2016,25(25):2761-2763.
[10]Heigl F,Hettich R,Lotz N,et al.Clinical benefit of long-term lipoprotein apheresis in patient with severe hypercholesterolemia or Lp(a)-hyperlipoproteinemia with progressive cardiovascular disease[J].Clin Res Cardiol Suppl,2015,10:33-38.
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