摘要
目的:探讨冠心病患者血清脂蛋白a水平与冠状动脉病变程度的关联。方法:对我科2002年4月～2010年7月连续8年1 260例住院临床诊断或疑诊冠心病患者行冠状动脉造影检查并同时进行血脂检测资料进行回顾性分析,按年龄分为青中年组(31～59岁)217例,老年组(60～74岁)561例和高龄老年组(75～93岁)482例。各年龄组患者根据冠状动脉造影结果分为冠心病组和对照组。分别对不同年龄组的甘油三酯(Triglycerides,TG)、血清总胆固醇(Total cholesterol,TC)、高密度脂蛋白胆固醇(High-density lipoprotein cholesterol,HDL-C)、低密度脂蛋白胆固醇(Low-density lipoprotein cholesterol,LDL-C)、游离脂肪酸(Free fatty acids,FFA)、脂蛋白a[Lipoprotein(a),Lp(a)]、载脂蛋白A1(Apolipoprotein A1,ApoA1)、载脂蛋白B(Apolipoprotein B,ApoB)等指标与冠脉病变程度进行相关分析。结果:老年和高龄老年组中冠心病患者血清Lp(a)、TC、LDL-C水平较对照组增高或显著增高(P<0.05或P<0.01),高龄老年组冠心病患者血清HDL-C较对照组降低(P<0.05);青中年组冠心病患者血清Lp(a),ApoB也较对照组显著增高(P<0.05或P<0.01)。在中青年、老年及高龄老年冠心病患者组间Lp(a)水平比较无统计学差异。在不同年龄组间,高龄老年冠心病组中冠状动脉狭窄支数较老年冠心病组及中青年冠心病组均有显著增加(P<0.01);高龄老年冠心病组中Gensini积分较老年冠心病组及中青年冠心病组均有显著升高(P<0.01)。对冠状动脉狭窄支数及狭窄程度进行有序多分类Logistic回归分析显示,Lp(a)、LDL-C和增龄进入回归方程(P<0.05或P<0.01)。结论:Lp(a)、LDL-C和增龄均是冠心病的独立危险因素,共同促进冠状动脉粥样硬化的发生发展。
Objective：To explore the relevance between the level of serum lipoprotein（a） and the severity of coronary artery disease and coronary heart disease.Methods：All of the 1 260 patients suspected/diagnosed as CHD in our department from April 2002 to March 2010 accepted coronary angiography,subsequently being divided into CHD group and control group according to the results of coronary angiography.Simultaneously,we conducted correlation analysis on the indexes of TG,TC,HDL-C,LDL-C,FFA,Lp（a）,ApoA1,ApoB as well as the pathological changes of coronary heart disease.And finally through multiple regression analysis,the correlation between the degree of coronary artery disease and multiple risk factors was analyzed.Results：The Lp（a）,TC,and LDL-C of the patients in the CHD group were higher than in the control group（the elderly group P0.05 and the very elderly group P0.01）,and HDL-C of the patients in the elderly group was lower than that in the control group（P0.05）.In the younger group,Lp（a） and ApoB were higher（P0.01 P0.05） in the CHD group.In all age groups,no significant difference was found about Lp（a）.The number of branch lesions and Gensini＇s score were higher in the very elderly group than those in the elderly and younger group（P0.01）.Logistic regression showed that Lp（a）,aging and LDL-C were independent risk factors for coronary heart disease and the severity of coronary artery stenosis.Conclusion：Lp（a）,LDL-C and aging are independent risk factors for coronary heart disease.
出处
《重庆医科大学学报》
CAS
CSCD
北大核心
2011年第11期1356-1360,共5页
Journal of Chongqing Medical University
关键词
脂蛋白A
冠心病
增龄
lipoprotein（a）
coronary artery disease
aging
