脂蛋白α和循环氧化低密度脂蛋白在主动脉瓣钙化性疾病中的水平及临床意义  

Levels and clinical significance of lipoprotein alpha and circulating oxidized low-density lipoprotein in calcific aortic valve disease

作　　者：苏国宝[1] 席茜 周朝元[1] 李保春 叶晨吉 Su Guobao;Xi Xi;Zhou Chaoyuan;Li Baochun;Ye Chenji(Department of Cardiovascular Surgery,the First Affiliated Hospital of Xinxiang Medical University,Weihui 453100,China;Department of Operating Room 2,the First Affiliated Hospital of Xinxiang Medical University,Weihui 453100,China;Xinxiang Medical University/Henan Provincial Key Laboratory of Medical Tissue Regeneration,Xinxiang 453000,China)

机构地区：[1]新乡医学院第一附属医院心血管外科,卫辉453100 [2]新乡医学院第一附属医院手术室二部,卫辉453100 [3]新乡医学院/河南省医用组织再生重点实验室,新乡453000

出　　处：《中华实验外科杂志》2024年第5期936-939,共4页Chinese Journal of Experimental Surgery

基　　金：河南省科技攻关计划项目(LHGJ20230493)。

摘　　要：目的:探讨脂蛋白α[Lp(α)]和循环氧化低密度脂蛋白(ox-LDL)在主动脉瓣钙化性疾病(CAVD)中的水平及临床意义。方法:选取2018年8月至2023年12月新乡医学院第一附属医院的55例CAVD患者(CAVD组)和41例无瓣膜病变患者(对照组)作为研究对象,通过双源CT检查将CAVD组分为3组:轻度钙化组、中度钙化组和重度钙化组。比较并分析治疗前CAVD组和对照组血清Lp(α)和ox-LDL水平;比较并分析轻度钙化组、中度钙化组和重度钙化组血清Lp(α)和ox-LDL水平;比较并分析治疗前后CAVD组患者血清Lp(α)和ox-LDL水平。采用Pearson相关分析血清Lp(α)和ox-LDL水平与Agatston积分的关系。结果:CAVD组患者的Lp(α)和ox-LDL水平[(409.20±134.55)mg/L、(49.44±16.02)ng/ml]明显高于对照组[(173.94±71.09)mg/L、(14.40±7.32)ng/ml,t=10.08、12.89,P<0.05]。重度钙化组患者的Lp(α)和ox-LDL水平[(566.81±47.19)mg/L、(68.31±7.05)ng/ml]明显高于中度钙化组[(410.57±76.29)mg/L、(50.07±6.96)ng/ml]和轻度钙化组[(259.08±54.99)mg/L、(30.88±6.37)ng/ml,t=7.05、7.72、16.67、15.54,P<0.05]。Pearson相关分析结果显示,CAVD患者血清Lp(α)和ox-LDL水平与Agatston积分呈正相关(r=0.73、0.75,P<0.05)。CAVD患者治疗后的Lp(α)和ox-LDL水平[(273.51±93.99)mg/L、(31.66±8.70)ng/ml]明显低于治疗前[(409.20±134.55)mg/L、(49.44±16.02)ng/ml,t=6.08、7.17,P<0.05]。结论:Lp(α)和ox-LDL参与CAVD的发展,其水平变化与疾病的严重程度密切相关,是早期诊断和监测评估主动脉瓣钙化性疾病的良好预测因子。Objective To investigate the levels and clinical significance of lipoprotein alpha[Lp(α)]and circulating oxidized low-density lipoprotein(ox-LDL)in calcific aortic valve disease(CAVD).Methods Totally,55 patients with CAVD(CAVD group)and 41 patients without valvular lesions(control group),who were admitted to our hospital from August 2018 to December 2023,were selected for the study.The CAVD group was divided into 3 groups by dual source CT examination:mild calcification group,moderate calcification group and severe calcification group.Serum Lp(α)and ox-LDL levels were compared and analyzed in the CAVD and control groups before treatment.Serum Lp(α)and ox-LDL levels were compared and analyzed in the mild calcification group,moderate calcification group and severe calcification group.Serum Lp(α)and ox-LDL levels in the CAVD group were compared and analyzed before and after treatment.Pearson’s correlation was used to analyze the relationship between serum Lp(α)and ox-LDL and Agatston score.Results Patients in the CAVD group[409.20±134.55)mg/ml,(49.44±16.02)ng/ml]had significantly higher levels of Lp(α)and ox-LDL than those in the control group[(173.94±71.09)mg/L,(14.40±7.32)ng/ml,t=10.08,12.89,P<0.05].Patients in the severe calcification group[566.81±47.19)mg/L,(68.31±7.05)ng/ml]had significantly higher levels of Lp(α)and ox-LDL than moderate calcification group[(410.57±76.29)mg/L,(50.07±6.96)ng/ml]and mild calcification group[(259.08±54.99)mg/L,(30.88±6.37)ng/ml,t=7.05,7.72,16.67,15.54,P<0.05].Pearson correlation analysis showed that serum Lp(α)and ox-LDL levels were positively correlated with Agatston score in CAVD patients(r=0.73,0.75,P<0.05).Lp(α)and ox-LDL levels were significantly lower in CAVD patients after treatment[273.51±93.99)mg/L,(31.66±8.70)ng/ml]than before treatment[(409.20±134.55)mg/L,(49.44±16.02)ng/ml,t=6.08,7.17,P<0.05].Conclusion Lp(α)and ox-LDL are involved in the development of CAVD,and changes in their levels correlate closely with the severity of the disease,making

关 键 词：主动脉瓣钙化 脂蛋白Α 低密度脂蛋白 临床意义 

分 类 号：R542.52[医药卫生—心血管疾病]