氧化型脂蛋白(a)和冠心病的相关性研究

目的探讨氧化型脂蛋白(a)和冠心病的相关性。方法行择期冠状动脉造影术的患者366例,于术前采血测定血清脂蛋白(a)和氧化型脂蛋白(a)的含量。结果冠心病组患者的脂蛋白(a)含量(90.5 mg/L),明显高于非冠心病组(64.0 mg/L),差异有统计学意义(P<0.05);冠心病组的氧化型脂蛋白(a)含量(0.09 nmol/L)亦明显高于非冠心病组(0.05 nmol/L),差异有统计学意义(P<0.05);但仅氧化型脂蛋白(a)与冠状动脉病变的Gensini评分相关(r=0.122,P<0.05)。多变量逐步logistic回归分析显示年龄(P<0.01)、男性(P<0.01)、糖尿病(P<0.01)、高脂血症史(P<0.01)、低高密度脂蛋白血症(P<0.01)及血清氧化型脂蛋白(a)含量的上四分位(P<0.05)是冠心病的独立危险因素。结论氧化型脂蛋白(a)而非脂蛋白(a)是冠心病的独立风险因子。

Relationship between oxidized lipoprotein(a) and coronary artery disease

Objective To explore the association of oxidized lipoprotein(a)(oxLp(a)) and the status of coronary artery disease(CAD).Methods Serum concentrations of lipoprotein(a)(Lp(a)) and oxLp(a) were measured in 366 patients who underwent elective coronary angiography.Results Lp(a) and oxLp(a) levels were significantly higher in patients with CAD compared with those without CAD(Lp(a) 90.5 mg/L vs 64.0 mg/L,P<0.05;oxLp(a) 0.09 nmol/L vs 0.05 mmol/L,P<0.05,resepectively.However,oxLp(a) concentration,but not Lp(a) concentration,was weakly but significantly related with the extent and severity of coronary lesions assessed by Gensini scoring system(rs=0.122,P<0.05).By multivariate stepwise logistic analysis,age(P<0.01),male(P<0.01),history of diabetes(P<0.01) or hyperlipidemia(P<0.01),HDL cholesterol(P<0.01) and oxLp(a) concentration(P<0.05) were independently associated with the presence of CAD.Conclusion Serum oxLp(a) but not native Lp(a) concentration may be an independent risk factor of coronary artery disease.