摘要
目的 探究未经治疗的冠心病(CAD)患者中,脂蛋白α[Lp(α)]在预测CAD发病和严重程度方面的作用.方法 连续入选2012年10月至2017年4月于阜外医院血脂异常与心血管疾病诊治中心的1980例接受冠状动脉造影的患者,其中1162例确诊患有CAD,用Gensini评分(GS)来评估CAD严重程度,免疫比浊法测定Lp(α).结果 与无CAD患者相比,CAD患者LDL-C水平更高(P<0.05).多变量Logistic回归分析表明,Lp(α)>205 mg/L(第三分位)时患CAD的风险是Lp(α)处于第一分位者的1.437倍(95%CI 1.108~1.865,P=0.006),高GS的风险是Lp(α)处于第一分位者的1.480倍(95%CI 1.090~2.009,P=0.012).而且,高水平的Lp(α)和LDL-C并存时预示着CAD发病风险(OR=1.845,95%CI 1.339~2.541,P<0.001)和冠状动脉严重程度(OR=1.736,95%CI 1.188~2.538,P=0.004)最高.结论 脂蛋白α可作为预测冠状动脉疾病存在和程度的标志物,尤其是与LDL-C联合使用时.
Objective To explore the lipoprotein(a)Lp(a)on predicting the presence and severity of coronary artery disease(CAD)in Chinese untreated patients.Methods We consecutively recruited 1980 nontreated patients undergoing coronary angiography in the division of dyslipidemia of Fu Wai Hospital from October 2012 to April 2017,among which 1162 patients were diagnosed with CAD.Gensini score(GS)was used to assess the severity of CAD.Lp(a)was measured by immunoturbidimetric method.Results Patients with CAD had higher level of low-density lipoprotein cholesterol(LDL-C)and Lp(a)compared with non-CAD(P<0.05).Multivariable Logistic regression revealed that Lp(a)>205 mg/L(highest tertile)predicted 1.437-fold risk for CAD(95%C/1.108-1.865,P=0.006)and 1.480-fold risk for high GS(95%671.090-2.009.P=0.012)respectively.Moreover,concomitant elevated level of Lp(a)and LDL-C meant the highest risk for both presence(OR=1.845,95%C/1.339-2.541.P<0.001)and severity(0R=1.736,95%C71.188-2.538,P=0.004)of CAD.Conclusion Lp(a)may be a useful marker for predicting the presence and severity of CAD,especially combined with LDL-C.
作者
热那提·肉孜
吴娜琼
孙荻
刘硕霖
郭远林
董倩
李建军
REN ATI Rouzi;WU Na-qiong;SUN Di;LIU Shuo-lin;GUO Yuan-lin;DONG Qian;LI Jian-jun(Endocrinology'&Cardio-metabolic Center.Department of Cardiology.State Key Laboratory of Cardiovascular Disease,Fu Wai Hospital.National Center for Cardiovascular Disease,Chinese Academy of Medical Sciences and Peking Union Medical College.Beijing 100037,China)
出处
《中国心血管病研究》
CAS
2020年第3期206-211,共6页
Chinese Journal of Cardiovascular Research
关键词
脂蛋白Α
低密度脂蛋白胆固醇
冠状动脉疾病
Lipoprotein(a)
low-density lipoprotein cholesterol(LDL-C)
Coronary artery disease
