脂蛋白a与冠状动脉钙化进展的相关性研究  

Analysis association the between lipoprotein a and the progression of coronary artery calcification

作　　者：甘建祥 潘昌[1] 孔肖寒 陈亮[1] GAN Jianxiang;PAN Chang;KONG Xiaohan;CHEN Liang(Department of Cardiology,Nanjing First Hospital,Nanjing 210000,China)

机构地区：[1]南京医科大学附属南京医院心血管内科,210000

出　　处：《心肺血管病杂志》2025年第3期246-251,共6页Journal of Cardiovascular and Pulmonary Diseases

基　　金：江苏省临床医学科技专项资金(BE201961)。

摘　　要：目的:本研究旨在进一步探讨脂蛋白a[Lipoprotein a,Lp(a)]与冠状动脉钙化进展的相关性。方法:本研究主要回顾性纳入2020年1月至2020年12月,于我院行冠状动脉CTA检查,且在随后2~3年复查冠状动脉CTA的患者。依据冠状动脉钙化积分(coronary artery calcium score,CACS)演变,将患者分为冠状动脉钙化进展组与冠状动脉钙化非进展组。结果:本研究共回顾性纳入265例患者,随后2~3年内共有121例发生了冠状动脉钙化进展。与冠状动脉钙化非进展组相比,冠状动脉钙化进展Lp(a)水平均相对较高[23.0(7.0,43.0)vs.9.5(4.0,27.8)mmol/L,P<0.001]。此外,冠状动脉钙化进展组Lp(a)≥75.0 mmol/L的患者比率亦相对较高(41.3%vs.22.9%,P=0.001)。进一步在单因素回归分析中证实,Lp(a)与冠状动脉钙化进展紧密相关。通过多因素回归分析校正其他因素影响后,Lp(a)无论作为连续性变量(OR=1.0,95%CI:1.007~1.030,P=0.001)还是分类变量(OR=2.4,95%CI:1.314~4.028,P=0.004)均是冠状动脉钙化进展的独立危险因素。受试者工作特征曲线进一步证实Lp(a)可有效预测冠状动脉钙化进展的发生(曲线下面积0.6,95%CI:0.578~0.710)。结论:Lp(a)水平是冠状动脉钙化进展的独立危险因素。Lp(a)水平升高者(≥75.0 mmol/L)未来发生冠状动脉钙化进展风险亦相对较大。Objective:This study aims to further explore the association between lipoprotein a[Lp(a)]and the progression of coronary artery calcification.Methods:This study retrospectively included patients who underwent coronary CTA examination at our hospital from January 2020 to December 2020,and had followup coronary CTA examinations 2-3 years later.According to the evolution of coronary artery calcification score(CACS),patients were divided into two groups:the group with the progression of coronary artery calcification and the group without the progression of coronary artery calcification.Results:A total of 265 patients were retrospectively enrolled in this study,and a total of 121 patients experienced progression of coronary artery calcification within the following 2-3 years.Compared with the group of without the progression of coronary artery calcification,the level of Lp(a)in the group with the progression of coronary artery calcification was relatively high[23.0(7.0,43.0)vs.9.5(4.0,27.8)mmol/L,P<0.001].In addition,the proportion of patients with Lp(a)≥75.0 mmol/L in the group with the progression of coronary artery calcification was also relatively high(41.3%vs.22.9%,P=0.001).Further single factor regression analysis confirmed that Lp(a)is closely related to the progression of coronary artery calcification.After adjusting for other factors through multiple regression analysis,Lp(a)is an independent risk factor for the progression of coronary artery calcification,whether as a continuous variable(OR=1.0,95%CI:1.007-1.030,P=0.001)or a categorical variable(OR=2.4,95%CI:1.314-4.028,P=0.004).The receiver operating characteristics curve further confirms that Lp(a)can effectively predict the occurrence of coronary artery calcification progression(area under the curve 0.6,95%CI:0.578-0.710).Conclusions:Lp(a)levels are an independent risk factor for the progression of coronary artery calcification.Individuals with elevated Lp(a)levels(≥75.0 mmol/L)also have a relatively higher risk of developing coronary artery calcifica

关 键 词：脂蛋白A 冠状动脉钙化 冠状动脉CT血管造影 

分 类 号：R54[医药卫生—心血管疾病]