脂蛋白(a)水平升高与老年冠心病的关系研究  

Association between lipoprotein (a) and coronary heart disease in old patients

作　　者：徐晨凯[1] 陈晓锋 庞晓红 金红峰[1] 杜常青[1] 刘小伟[1] 王云龙 娄江杰 唐礼江[4,1] XU Chenkai;CHEN Xiaofeng;PANG Xiaohong(Department of Cardiology,Zhejiang Hospital,Hangzhou 310013,China)

机构地区：[1]浙江医院心内科,杭州310013 [2]浙江台州医院心内科 [3]温州医科大学 [4]温州医科大学第一临床医学院

出　　处：《浙江医学》2018年第11期1154-1157,共4页Zhejiang Medical Journal

基　　金：浙江省医药卫生重大科技计划项目(2015128660);浙江省公益技术研究计划项目(LGJ18H020001)

摘　　要：目的探讨老年人群脂蛋白(a)[Lp(a)]水平升高与冠心病的相关性。方法连续入组2015年1月至2016年1月行冠状动脉造影老年患者(≥65岁),其中684例患者诊断为冠心病,158例患者冠状动脉正常。比较两组患者的血浆Lp(a)水平及临床特征,利用logistic回归模型分析血浆Lp(a)水平与冠心病风险的相关性。结果冠心病患者TC、LDL-C及Lp(a)水平均显著高于对照组,差异均有统计学意义(均P<0.05)。冠心病患者中Lp(a)水平≥300mg/L亚组冠状动脉三支病变发生率要高于Lp(a)水平<300mg/L亚组(P=0.048)。Logistic回归分析显示Lp(a)是老年冠心病的独立危险因素(OR=1.7,P=0.012)。结论血浆Lp(a)水平的升高是老年冠心病独立危险因素同时,并使冠状动脉病变严重程度增加。Objective To explore the correlation between plasma level of lipoprotein（a）[Lp（a）]and CHD（coronary heart disease） in old patients（aged ≥65）. Methods We analysis data of all consecutive old patients admitted to the Department of Cardiovascular, Zhejiang Hospital for coronary angiography between January 1 st, 2015 and January 1 st, 2016. Of all 684 CHD patients and 158 coronary normal person aged≥65 underwent CAG were identified. Statistical analyses were performed to compare their baseline Lp（a） levels and clinical feature. The predictive power of Lp（a） for CHD was determined by logistic regression. Results Of the patients admitted for coronary angiography, the mean age was 73 ± 6 years. Compared with patients without CHD, those with CHD had higher mean total cholesterol（P=0.007）, higher low-density lipoprotein cholesterol（P=0.002）, higher Lp（a）（P=0.046）. For CHD patients aged ≥65 years old, serum Lp（a）≥300（mg/L） had showed a graded association with the extent of coronary artery disease（P=0.048）. Lp（a） was a statistically significant predictor of the presence of CHD using logistic regression（OR=1.7, P=0.012）. Conclusion Elevation of serum Lp（a） level predict the presence of CHD and showed a graded association with the extent of coronary artery disease in patients aged ≥65 years.

关 键 词：脂蛋白(a) 老年 冠心病 独立危险因素 

分 类 号：R541.4[医药卫生—心血管疾病]