脂蛋白(a)颗粒水平与早发性冠脉粥样硬化的相关性分析  

The correlation analysis between lipoprotein(a)levels and early coronary atherosclerosis

作　　者：朱晶[1] 徐世骥 吴炯[1] 张春燕 王蓓丽[1] 郭玮[1] 潘柏申[1] 

机构地区：[1]复旦大学附属中山医院检验科,上海200032

出　　处：《复旦学报（医学版）》2016年第3期274-279,共6页Fudan University Journal of Medical Sciences

基　　金：国家自然科学基金面上项目(81572064);"十二五"国家科技支撑计划课题(2012BAI37B01);上海市卫生计生系统重要薄弱学科建设项目(2015ZB0201)~~

摘　　要：目的探讨血清脂蛋白（a）[lipoprotein（a）,Lp（a）]颗粒水平与早发性冠脉粥样硬化的相关性,研究以nmol/L为检测单位的Lp（a）试剂的临床应用价值。方法检测177名早发性冠脉粥样硬化患者和200名体检健康者（对照组）的血清Lp（a）颗粒水平,将检测结果与患者冠脉粥样硬化程度（以Gensini积分评估）和其他血清标志物进行相关性分析。结果该Lp（a）试剂的检测精密度在可接受范围内,浓度在2.65~235.20nmol/L的线性验证良好。在早发性冠脉粥样硬化组中有35.51%的患者Lp（a）颗粒水平升高,该比例显著高于对照组的4%（P〈0.001）。Lp（a）、胆固醇（cholesterol,CHO）、载脂蛋白B（apolipoprotein-B,APO-B）,肌酐（creatinine,CRE）、高敏C反应蛋白（high sensitivity C-reactive protein,hs-CRP）与早发性冠脉粥样硬化严重程度呈显著正相关（P〈0.05）。通过二元Logistic回归分析得到,Lp（a）（OR=2.883,P=0.004）与APO-B（OR=5.440,P=0.007）是早发性冠脉粥样硬化严重程度的独立风险因素。结论以nmol/L为检测单位,Lp（a）试剂的精密度和线性范围均符合实验室检测性能要求,适合于临床检验应用。血清Lp（a）颗粒水平是早发性冠脉粥样硬化严重程度的独立风险因子,可预测早发性冠脉粥样硬化的严重程度。Objective To evaluate the relationship between serum lipoprotein（a）[Lp（a）]level and early coronary atherosclerosis,and to validate the clinical application when using nmol/L as the unit of Lp（a）. Methods Serum Lp（a）level were dected in177 patients with early coronary atherosclerosis who underwent angiography and 200 healthy individuals（the control group）.The correlation was analyzed between Lp（a）level and the severity of coronary artery disease,and between Lp（a）level and other biomarkers using Gensini Integrals. Results The detection imprecision of Lp（a）reagent＇s was in the acceptable range,and it was linear in the studied range of 2.65-235.20 nmol/L.The proportion of elevated serum Lp（a）level was significantly higher in the atherosclerosis group（35.51%）compared with the control group（4%）（P0.001）.Spearman＇s correlation analysis indicated that serum Lp（a）,cholesterol（CHO）,apolipoprotein-B（APO-B）,creatinine（CRE）,and high sensitivity C-reactive protein（hs-CRP）levels were positive correlated with the severity of early coronary atherosclerosis（P〈0.05）.Binary Logistic regression analysis demonstrated that serum Lp（a）and APO-B levels were significantly independently associated with the severity of coronary atherosclerosis（OR=2.883,P=0.004 and OR=5.440,P=0.007,respectively）. ConclusionsLp（a）reagent is reliable for laboratory test in precision and linear studies.When using nmol/L as the unit,Lp（a）is an independent risk factor for early coronary atherosclerosis,and could predict its severity.

关 键 词：脂蛋白(a) 早发性冠脉粥样硬化 检测性能验证 

分 类 号：R543.3[医药卫生—心血管疾病]