老年冠心病患者血清Lp-a、Hcy、和肽素水平变化及临床意义  

Changes of serum Lp-a,Hcy and copeptin levels in elderly patients with coronary heart disease and their clinical significance

作　　者：郝佳佳 陈汉青 丘惠嫦[1] HAO Jia-jia;CHEN Han-qing;QIU Hui-chang(Department of General Medicine,Guangzhou First People s Hospital,Guangzhou 510180,Guangdong,China)

机构地区：[1]广州市第一人民医院全科医学科,广东广州510180

出　　处：《川北医学院学报》2022年第10期1253-1256,共4页Journal of North Sichuan Medical College

基　　金：国家自然科学基金资助项目(32171370)。

摘　　要：目的:观察老年冠心病(CHD)患者血清脂蛋白-a(Lp-a)、同型半胱氨酸(Hcy)、和肽素水平变化及临床意义。方法:根据病变程度将300例老年CHD患者分为稳定型心绞痛(SAP)组(n=88)、不稳定型心绞痛(UAP)组(n=122)及急性心肌梗死(AMI)组(n=90),并根据冠脉病变血管支数分为单支病变组(n=100)、双支病变组(n=110)及多支病变组(n=90),同时选取同期行体检的60名健康者作为对照组;检测血清Lp-a、Hcy、和肽素水平,分析其与Gensini评分的相关性;采用Logistic多因素回归分析CHD发生的危险因素。结果:AMI组血清Lp-a、Hcy、和肽素水平和Gensini评分均高于SAP组和UAP组,UAP组均高于SAP组(P<0.05);多支病变组血清Lp-a、Hcy、和肽素水平均高于单支病变组和双支病变组;双支病变组均高于单支病变组(P<0.05)。Spearman相关分析显示,Gensini评分与血清Lp-a、Hcy、和肽素水平呈正相关(P<0.05)。Logistic回归分析显示,血清Lp-a、Hcy、和肽素水平升高是CHD发生的独立危险因素(P<0.05)。结论:血清Lp-a、Hcy、和肽素水平随冠状动脉病变程度和病变血管支数的增加呈升高趋势,可作为预测CHD及其病变情况的有效指标。Objective:To observe the changes of serum lipoprotein-a(Lp-a),homocysteine(Hcy)and copeptin levels in elderly patients with coronary heart disease(CHD),and their clinical significance.Methods:300 elderly patients with CHD were divided into stable angina pectoris(SAP)group(n=88),unstable angina pectoris(UAP)group(n=122)and acute myocardial infarction(AMI)group(n=90)according to severity of the disease.According to the number of diseased coronary artery,they were divided into single-vessel disease group(n=100),double-vessel disease group(n=110)and multiple-vessel disease group(n=90).Meanwhile,60 healthy individuals were selected as the control group.Serum Lp-a,Hcy and copeptin levels were detected,and their correlation with Gensini score was analyzed.Multivariate Logistic regression analysis was performed to screen the risk factors of CHD.Results:Serum Lp-a,Hcy and copeptin levels,and Gensini score of AMI group,UAP group,and SAP group decreased in order(P<0.05).Serum Lp-a,Hcy and copeptin levels of the multi-vessel disease group,the double-vessel disease group,and the single-vessel disease group decreased in order(P<0.05).Spearman correlation analysis showed that Gensini score was positively correlated with serum Lp-a,Hcy and copeptin levels(P<0.05).Logistic regression analysis showed that the increased levels of serum Lp-a,Hcy and copeptin were independent risk factors for CHD(P<0.05).Conclusion:Serum Lp-a,Hcy,and copeptin levels increase with the aggravation of coronary artery lesions and the increase of diseased vessels,which indicates that they can be used as effective indicators to predict CHD and its severity.

关 键 词：冠心病 脂蛋白-a 同型半胱氨酸 和肽素 临床意义 

分 类 号：R541.4[医药卫生—心血管疾病]