脂蛋白a与冠心病患者心肾功能的相关性研究  

The correlations of cardiac and renal functions with lipoprotein(a)in patients with coronary heart disease

作　　者：龚博君[1] 李自成[1] 

机构地区：[1]暨南大学附属第一医院心血管内科,广州510632

出　　处：《临床心血管病杂志》2014年第12期1049-1052,共4页Journal of Clinical Cardiology

基　　金：广东省科技计划项目(No:2010-1096-136);广州市科技计划项目(No:2010Y1-C941);暨南大学第一临床医学院重点学科基金(No:2010-4)

摘　　要：目的:探讨冠心病患者体内血清脂蛋白a[Lp(a)]与肾小球滤过率估测值(eGFR)和左室射血分数(LVEF)的相关性。方法:入选经冠状动脉(冠脉)造影检查确诊的冠心病住院患者555例。将所有患者根据性别分为两组。收集患者一般临床资料及冠脉造影结果。比较不同eGFR、LVEF及Gensini积分情况下Lp(a)的分布特征。采用Pearson相关分析法分析相关性,多元线性回归分析Lp(a)的影响因素。结果:1Lp(a)水平在不同性别、eGFR、LVEF和Gensini积分间的差异有统计学意义(均P<0.05)。与eGFR≥90(ml·min-1·1.73m-2)相比,60(ml·min-1·1.73m-2)≤eGFR<90(ml·min-1·1.73m-2)和eGFR<60(ml·min-1·1.73m-2)两组患者(ml·min-1·1.73m-2)水平更高(均P<0.05)。2Lp(a)与eGFR和LVEF呈负相关(均P<0.05),与性别、载脂蛋白B、Gensini积分、血肌酐、总胆固醇、低密度脂蛋白胆固醇及年龄呈正相关(均P<0.05)。在校正其他因素影响后,Lp(a)与性别、eGFR、载脂蛋白B、Gensini积分及LVEF仍有相关性(β值分别为0.094、-0.123、0.186、0.083和-0.074,均P<0.05)。结论:Lp(a)与载脂蛋白B、eGFR、LVEF和Gensini积分相关,对冠心病患者心肾功能有影响。Objective：To investigate the correlations of glomerular filtration rate（eGFR）and left ventricular e- jection fraction （LVEF） with lipoprotein（a）（Lp（a））in patients with coronary artery disease（CAD）. Method：A to- tal of five hundred and fifty-five hospitalized patients with CAD referred to coronary angiography（CAG）were en- rolled. All the patients in accordance with gender were divided into two groups. Clinical and biochemical latoratory data and results of coronary angiography were collected. Distribution characteristics of Lp（a）was compared in CAD patients with various eGFR, LVEF and Gensini Score. Using Linear correlation analysis to explore the relativity. Risk factors for Lp（a）were determined by multiple linear regression analysis. Result： There were significantly differences between various eGFR, LVEF, Gensini Score and Lp（a）（all P〈0.05）. Lp（a）was positively correlated with gender, apolipoprotein B（Apo B）, Gensini score, Serum creatinine （ SCr）, total cholesterol （TC）, low density lipoprotein cholesterol （LDL-C） and age,and negatively correlated with eGFR and LVEF（all P〈0.05）. After adjusting for other factors, the relationship between gender, eGFR, ap0 B, Gensini score, LVF-F and Lp （a） remained significant（all P〈0.05）. Conclusion： Lp（a） is closely related to cardiovascular risk factors including apoB,eGFR, LVEF and Gensini score.

关 键 词：脂蛋白(a) 肾小球滤过率估测值 左室射血分数 

分 类 号：R541.4[医药卫生—心血管疾病]