老年慢性肾功能衰竭患者血清唾液酸和脂蛋白(a)的测定

目的　研究老年慢性肾功能衰竭 (chronicrenalfailure ,CRF)患者血清中唾液酸和脂蛋白 (a)水平的变化及其临床意义。方法　采用单一试剂显色法测定唾液酸 ,用透射比浊法检测载脂蛋白 (a) ,对 4 5例健康青年组、33例健康老年组和 38例老年CRF组进行测定。结果　老年CRF患者血清唾液酸 [(76 3± 15 8.6 )mg/L]及脂蛋白 (a)[(2 19.6± 97.3)mg/L]水平均明显高于健康青年组 [(5 2 3±72 .8)mg/L、(111.3± 72 .8)mg/L]和健康老年组 [(5 86± 92 .7)mg/L]、[(14 1.4± 10 1.2 )mg/L],差异有显著意义 (P <0 .0 1)。但健康老年组与青年健康组血清唾液酸含量则无明显变化。老年CRF患者血中唾液酸和脂蛋白 (a)水平有一定的相关性 (r =0 .80 5 ,P <0 .0 5 )。结论　检测血清唾液酸和脂蛋白 (a) ,对老年CRF患者病情的判定有一定价值 ,也可为临床提供更有价值的预防判断指标 ,对于临床治疗也具有指导意义     

Effect of hypertriglyceridaemia on lipoprotein (a) serum concentrations

Abstract. Numerous studies have shown lipoprotein (a) [Lp(a)] serum levels above 0.3 gL^-1to be a genetically determined and independent risk factor for atherosclerotic vascular disease. In this study of sera from 1009 patients attending our lipid clinics, multivariate regression analysis revealed an inverse correlation between the serum concentrations of triglycerides (TG) and Lp(a) ( r =—0.31; P < 0.001) as determined by electroimmunodiffusion. This was not observed in 1237 controls from a random population. Detailed analysis of the frequency distribution of Lp(a) levels at different degrees of hypertriglyceridaemia (HTG) revealed a decreasing dosage effect of HTG on Lp(a) serum levels. In 60% of patients with TG > 9.12mmolL^-1, this effect led to undetectable serum Lp(a) levels. Dilution of hypertriglyceridaemic samples with normotriglyceridaemic sera containing high levels of Lp(a) revealed that analytical interference in part accounts for the decreasing effect of TG-rich lipoproteins on Lp(a). Re-evaluation of 45 hypertriglyceridaemic samples by enzyme immuno-assay and immunoblotting revealed the presence of small amounts of Lp(a) in several samples which were considered to be free of Lp(a) upon electroimmunodiffusion. We conclude that TG-rich lipoproteins interfere with the quantification of Lp(a), at least by electroimmunodiffusion. However, HTG may also decrease Lp(a) plasma concentrations in vivo , possibly by increased clearance of TG-rich Lp(a).     

急性冠脉综合征患者血浆脂蛋白(a)测定的临床意义

目的探讨急性冠脉综合征患者血浆脂蛋白(a)测定的临床意义。方法因胸痛或胸部不适行选择性冠状动脉造影的患者494例,结合冠状动脉造影结果及临床诊断分成非冠心病组(NCHD,221例);冠心病稳定型心绞痛组(SAP,58例);冠心病急性冠脉综合征组(ACS,215例),其中不稳定型心绞痛(UAP,114例),ST段抬高型急性心肌梗死(STEMI,66例),非ST段抬高型急性心肌梗死(NSTEMI,35例),测定各组血浆Lp(a)浓度并进行分析比较。结果NCHD组、SAP组和ACS组Lp(a)测定值分别为(166．33±41．92)mg/L、(222．34±44．83)mg/L、(280．32±56．64)mg/L。ACS组Lp(a)测定值明显高于SAP组(F=9．26 P＜0．01)和NCHD组(F=8．13,P＜0．01)。结论急性冠脉综合征血浆Lp(a)浓度较之稳定型心绞痛和非冠心病明显增高,提示血浆Lp(a)增高不仅是冠心病的独立危险因素,也可能是急性冠脉事件的促发因素。     

缺血性脑卒中患者血清氧化脂蛋白(a)水平升高

摘要：目的：观察血清氧化脂蛋白(a)［ox-Lp(a)］水平及其与缺血性脑卒中（CIS）严重程度间的关系。 方法：分别检测93例CIS患者［按美国国立卫生研究院卒中量表（NIHS）评分分为轻型48例,重型45例］,脑出血患者30例和体检健康者48例血清ox-Lp(a)、Lp(a)水平并进行统计学分析。 结果：CIS轻型、重型患者血清ox-Lp(a)（t分别为-2.147、-5.082,P均＜0.05）、Lp(a)（t分别为-2.347、-4.187,P均＜0.05）水平均高于体检健康者,CIS重型患者血清ox-Lp(a)、Lp(a)水平均高于轻型组（t分别为-2.700、-0.231,P均＜0.05）和脑出血组（t分别为4.205、-2.180,P均＜0.05）。CIS患者血清ox-Lp(a)与Lp(a)水平呈正相关（r=0.429,P＜0.01）,与HDL-C水平呈负相关（r=-0.149,P＜0.01）;NIHSS与血清ox-Lp(a)、Lp(a)水平呈正相关（r分别为0.324、0.299,P均＜0.01）。多元线性回归分析显示血清ox-Lp(a)、Lp(a)共同决定了13.6%的NIHSS变化［β分别为0.246、0.243,P均＜0.05;决定系数（R²）=0.136)］。多元Logistic回归分析显示,校正年龄、性别和血脂水平等因素后,高ox-Lp(a)水平是CIS重型组的危险因素［风险比（OR）=1.209,95%可信区间（CI）=1.033~1.414］。 结论: CIS患者血清ox-Lp(a)水平升高,并与疾病严重程度相关。     

D-二聚体、NT-proBNP及脂蛋白(a)在急性缺血性脑卒中患者的水平及临床意义

目的研究D-二聚体、N末端-脑钠肽前体(NT-proBNP)及脂蛋白(a)在急性缺血性脑卒中患者的水平及临床意义。方法选择2013年3月至2015年3月接诊的150例急性缺血性脑卒中患者作为观察组进行研究。并选择同期进行健康体检者50例作为对照组。分别对2组对象的D-二聚体、NT-proBNP及脂蛋白(a)水平进行检测。依据神经功能缺损评分对脑卒中患者进行分组,对3项指标进行统计分析。结果观察组患者的D-二聚体、NT-proBNP及血清脂蛋白(a)水平明显高于对照组,2组比较差异有统计学意义(P0.05)。重型患者的D-二聚体、NT-proBNP及血清脂蛋白(a)水平明显高于轻型和中型,随着病情程度加重,3项指标的水平逐渐升高(P0.05)。腔隙性脑卒中患者的D-二聚体、NT-proBNP及血清脂蛋白(a)水平明显高于非腔隙性组患者(P0.05)。结论 D-二聚体、NT-proBNP及血清脂蛋白(a)在急性缺血性脑卒中患者诊断中临床诊断价值较高,值得广泛应用。     

Normal lipoprotein(a) concentrations and apolipoprotein(a) isoforms in patients with insulin-dependent diabetes mellitus

Lipoprotein(a) [Lp(a)] is an LDL particle in which apoliporotein B-100 is attached to a large plasminogen-like protein called apolipoprotein(a) [apo(a)]. Apo(a) has several genetically determined phenotypes differing in molecular weight, to which Lp(a) concentrations in plasma are inversely correlated, and plasma Lp(a) concentrations above 20-30 mg dl-1 are an independant risk factor for ischaemic heart disease (IHD). To investigate whether Lp(a) could be important for the high cardiovascular mortality rate in patients with insulin dependent diabetes mellitus (IDDM), we determined Lp(a) concentrations and phenotypes in a group of 108 men (median age 32 years) with IDDM without nephropathy. A group of 40-year-old men (n = 466) served as controls. The median Lp(a) concentration was 7.4 mg dl-1 [95% CI 4.9 to 11.7] in the diabetic patients and 6.3 mg dl-1 [95% CI 5.2 to 7.0] in controls. The Lp(a) concentration exceeded 30 mg dl-1 in 22% of IDDM patients and in 20% of controls (P = 0.13). Moreover, the distribution of apo(a) phenotypes did not differ between patients and control. Lp(a) levels and apo(a) phenotypes are thus apparently the same in IDDM patients without nephropathy and controls. These findings do not exclude the possibility that Lp(a) may be increased in patients with nephropathy in whom coronary artery disease frequently co-exist or that Lp(a) in a given concentration is more atherogenic in IDDM patients than in persons without IDDM.     

脂蛋白(a)是最敏感的急性时相蛋白

目的为寻找更为敏感的炎症标记蛋白。方法对５０例感染症病人及４１８例健康者血清脂蛋白（ａ）［Ｌｐ（ａ）］及转铁蛋白（ＴＲＦ）、结合珠蛋白（ＨＰ）、α１－抗胰蛋白酶（ＡＡＴ）、α１－酸性糖蛋白（ＡＡＧ）、α２－巨球蛋白（α２Ｍ）、铜蓝蛋白（ＣＰ）、前白蛋白（ＰＡＢ）、视黄醇连接蛋白（ＲｂＰ）和Ｃ－反应蛋白（ＣＲＰ）等９项急性时相蛋白进行了检测分析。结果炎症组Ｌｐ（ａ）均值为２５９．２ｍｇ／Ｌ，正常对照组Ｌｐ（ａ）均值为１２６ｍｇ／Ｌ，炎症组Ｌｐ（ａ）水平明显高于正常对照组，两组间差异有非常显著意义（Ｐ＜０．０１）；炎症组Ｌｐ（ａ）高于正常者占６２％（３１／５０），而其它９项急性时相蛋白中，除ＣＲＰ升高者占４２％，其余８项急性时相蛋白检测值升高者所占比例均＜４％。结论Ｌｐ（ａ）是最敏感的急性时相蛋白，是一种比其它急性时相蛋白更为敏感的炎症标记蛋白。     

血清脂蛋白(a)水平与高血压的相关性

目的探讨血清脂蛋白(a)[LP(a)]水平与高血压的相关性。方法对入选的300例患者(高血压患者178例,非高血压患者122例)进行信息采集(性别、年龄、体质量、身高、吸烟史、饮酒史、糖尿病、心脏病、动脉硬化等疾病史)、血压测量、血液生化检验[LP(a)]。结果本组资料总人群LP(a)中位数为97.5 mg/L,高血压组为104.5 mg/L,非高血压组为73.3 mg/L,2组差异有统计学意义(P0.05)。在高血压组LP(a)300 mg/L比例较非高血压组高,差异有统计学意义(P0.05)。对高血压相关影响因素进行Logistic回归分析,经变量筛选后得到的主要影响因素为年龄(OR=1.067,95%CI为1.040~1.095)。结论高血压人群中血清LP(a)水平较非高血压人群高,但LP(a)可能并非是高血压发生发展的主要危险因素。     

High lipoprotein(a) levels with predominance of high molecular weight apo(a) isoforms in patients with pulmonary embolism

Abstract. Lipoprotein(a) (Lp(a)) may interact with the cellular components and protein co-factors of fibrino-lysis. To evaluate the effect of Lp(a) in thromboem-bolic diseases of the venous system, we measured serum levels and the isoform distribution of apo(a) in 25 patients with pulmonary embolism (18 men, 7 women, aged 21—77 years). The control group was adjusted for sex and age ( P = 0.189). Serum Lp(a) concentration was significantly higher in the study group (median: 9.3 vs. 4.3 mg dL^-1). As the distribution of high and low molecular weight subtypes of apo(a) did not show any differences ( P = 0.127) between the two groups, the elevated Lp(a) levels in patients with pulmonary embolism could not be attributed to the investigated kringle-4 polymorphism of the apo(a) gene and therefore other genetic or non-genetic implications are indicated.     

血清同型半胱氨酸和唾液酸联合检测对急性冠状动脉综合征诊断的意义

目的 研究血清同型半胱氨酸(Hcy)及唾液酸(SA)对急性冠状动脉综合征(ACS)的诊断价值和临床意义.方法 以31例急性心肌梗死(AMI)患者(AMI组)、35例不稳定型心绞痛(UA)患者(UA组)及53例体检健康者(对照组)作为研究对象,测定Hcy、SA及包括总胆固醇(CH)、三酰甘油(TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、载脂蛋白AⅠ(ApoAⅠ)、载脂蛋白B(APOB)及脂蛋白(a)[LP(a)]在内的血脂指标.采用统计学方法分析相关指标.结果 AMI组血清Hcy及SA水平高于UA组及对照组(P<0.05);UA组血清Hcy及SA水平高于对照组(P<0.05);除ApoAⅠ外,其余血脂指标的血清浓度在各组间的差异均无统计学意义(P＞0.05).在本研究所有的生物标志中,仅血清Hcy和SA与AMI或UA的发生有关(P<0.05).血清SA单独检测诊断AMI/UA的ROC曲线下面积分别为94.2%/94.5%,远高于血清Hcy诊断AMI/UA时的ROC曲线下面积84.4%/76.7%.联合血清Hcy后,血清SA对AMI或UA的诊断水平得到进一步的加强.结论 测定血清Hcy和SA水平对ACS的预防及治疗监测具有重要的临床意义,两者的联合检测可提高对ACS的诊断水平.     

Comparative study of total protein,and total and lipid-associated serum sialic acid levels in patients with type 2 diabetes mellitus

The aim of the present study was to investigate the serum total protein (TP), total sialic acid (TSA), lipid-associated sialic acid (LSA), LSA/TP, and LSA/TP values in type 2 diabetes mellitus (DM) patients. Two study groups (healthy controls and type 2 DM subjects) were examined. For the type 2 DM group, 120 patients (60 females and 60 males) who had been diagnosed and treated for type 2 DM in the Yuzuncu Yil University Hospital, Van, Turkey, were selected consecutively. Forty healthy individuals (20 females and 20 males) were selected from hospital staff and other outpatient clinics to serve as the control group. They were matched for age, sex, body mass index, and smoking status. None of the participants had taken vitamin or mineral supplements for at least 2 weeks before sampling. To determine serum glucose, TP, TSA, and LSA levels, blood samples were drawn after all of the subjects fasted overnight. It was found that diabetics had higher TSA, LSA, TSA/TP, and LSA/TP levels than controls. However, the TP levels were not significantly different between the groups. Our results showed that TSA, LSA, TSA/TP, and LSA/TP have interactive connections with DM. These parameters can be used as a diagnostic index for patients with DM.     

尿毒症非透析患者的微炎症状态及对脂蛋白(a)的影响

目的　通过测定尿毒症非透析患者慢性炎症指标并分析其与脂蛋白 (a) [Lp(a) ]的关系 ,探讨非透析的尿毒症患者微炎症状态及其影响心血管系统的途径。方法　测定 5 5例尿毒症患者慢性炎症指标血C 反应蛋白(CRP)、白细胞介素 6 (IL 6 )、肿瘤坏死因子α(TNF α)及Lp(a) ,分析它们之间的关系 ,并与 30例正常人比较。结果　尿毒症组血CRP、IL 6、TNF α及Lp(a)分别为 (4 .0 6± 4 .0 2 )mg/L、(10 8.3± 88.3)ng/L、(1.4 1± 0 .5 3) μg/L和 (5 5 0± 4 31)mg/L ,均高于对照组 ,其中CRP、TNF α及Lp(a)与正常组比较差异有统计学意义 ;尿毒症患者血Lp(a)与CRP、TNF α、IL 6呈明显正相关 (r值分别为 0 .6 32、0 .4 2 5、0 .4 0 5 ,均P <0 .0 1)。结论　尿毒症患者存在微炎症状态 ;炎症可能通过引起Lp(a)代谢紊乱 ,对心血管系统产生不利影响     

Effect of insulin treatment on serum lipoprotein(a) in non-insulin-dependent diabetes

Abstract. In order to evaluate whether Lp(a), a lipoprotein that is potentially thrombogenic and atherogenic, is a potential risk factor for CAD in non-insulin-dependent diabetes (NIDDM), we compared the Lp(a) and its distribution in 145 NIDDM patients with that in 94 healthy control subjects. Furthermore, we studied the effect of insulin treatment on serum Lp(a) in 108 patients with NIDDM. Male and female NIDDM patients had similar Lp(a) concentrations to healthy controls (median value 167 mg L^-1, range 15–1550 mg L^-1 vs. 157 mg L^-1, range 15–919 mg L^-1, NS and 92, range 15–1190 mg L^-1 vs. 103 mg L^-1, range 15–842 mg L^-1, NS). Also, the cumulative distribution of Lp(a) did not differ between the NIDDM patients and healthy subjects. Insulin treatment increased Lp(a) in diabetics with a Lp(a) concentration of less than 300 mg ^-1L, but this effect was not related to the concomitant improvement in metabolic control (mean change (±SEM) of HbA_1c from 9.80±0.15 to 8.00±0.12; P < 0.001). In subjects with elevated Lp(a) concentrations (>300 mg L^-1) the Lp(a) concentration was unaffected by insulin, despite a similar improvement in glycaemic control. These results suggest that insulin may modulate the concentration of Lp(a).     

经皮冠状动脉介入导致ACS患者脂蛋白(a)和氧化脂蛋白(a)水平升高机制研究

目的 研究PCI治疗对ACS患者脂蛋白(a)[Lp(a)]、氧化脂蛋白(a)[ox-Lp(a)]水平的影响和机制.方法 收集75例ACS患者PCI前、后、24 h、2 d、3 d和6个月后各时间点,以及29例未行PCI术的对照组冠状动脉造影前、后血标本;采用ELISA法测定Lp(a)、OX-Lp(a)、Lp(a)免疫复合物[Lp(a)-IC]和自身抗体水平;冠状动脉造影确认病变程度.手术前后各指标的变化采用配对t检验;PCI前、后不同时间点Lp(a)、ox-Lp(a)相对变化值间比较采用方差分析;Lp(a)与ox-Lp(a)、冠状动脉病变程度与Lp(a)、ox-Lp(a)变化值间相关性采用直线相关分析.结果 PCI术后Lp(a)水平[233.10(152.86～328.79)mg/L]高于术前[202.05(106.15～271.42)mg/L],差异有统计学意义(数据经对数转换后分析,t=6.81,P<0.01);PCI术后ox-Lp(a)[19.05(10.98～31.80)mg/L]与术前[10.51(4.98～17.97)mg/L]相比升高,差异有统计学意义(数据经对数转换后分析,t=13.22,P<0.01);PCI术后Lp(a)-IC[2.72(1.60～4.91)AU]与术前[2.11(1.04～3.97)AU]相比升高,差异有统计学意义(数据经对数转换后分析,t=3.34,P<0.01);而PCI术后自身抗体(A=0.81±0.33)与术前(A=0.72±0.28)相比降低,差异有统计学意义(t=5.58,P<0.01).PCI前(r=0.66,P<0.01)、后(r=0.62,P<0.01)ox-Lp(a)水平均与Lp(a)高度相关.PCI导致Lp(a)、ox-Lp(a)水平急速升高,24 h内快速下降,2～3 d内接近术前水平.Lp(a)、ox-Lp(a)变化值均与冠状动脉病变程度呈正相关.对照组造影前后Lp(a)、ox-Lp(a)、Lp(a)-IC和Lp(a)自身抗体水平均无变化.结论 PCI导致ACS患者Lp(a)、ox-Lp(a)水平升高,其增加值与冠状动脉病变程度相关.     

Influence and interaction of diabetes and lipoprotein (a) serum levels on mortality of patients with peripheral artery disease

BACKGROUND: Diabetes mellitus is a risk factor for early complications and mortality in patients with peripheral artery disease. Lipoprotein (a) [Lp(a)] is also suggested to be a marker of increased cardiovascular risk. We investigated the association and interaction between diabetes mellitus, lipoprotein(a) and mortality in high risk patients with peripheral artery disease (PAD). METHODS: We studied 700 consecutive patients [median age 73 years, interquartile range (IQR) 62-80, 393 male (56%)] with PAD from a registry database. Atherothrombotic risk factors (diabetes, smoking, hyperlipidaemia, arterial hypertension) and Lp(a) serum levels were recorded. We used stratified multivariate Cox proportional hazard analyses to assess the mortality risk at a given patient's age with respect to the presence of diabetes and Lp(a) serum levels (in tertiles). RESULTS: Patients with Lp(a) levels above 36 mg dL(-1) (highest tertile) and insulin-dependent type II diabetes had a 3.01-fold increased adjusted risk for death (95% confidence interval 1.28-6.64, P = 0.011) compared to patients without diabetes or patients with non-insulin-dependent type II diabetes. In patients with Lp(a) serum levels below 36 mg dL(-1) (lower and middle tertile), diabetes mellitus was not associated with an increased risk for death. CONCLUSION: Insulin-dependent type II diabetes mellitus seems to be associated with an increased risk for mortality in PAD patients with Lp(a) serum levels above 36 mg dL(-1). PAD patients with non-insulin-dependent type II diabetes, and patients with diabetes and Lp(a) levels below 36 mg dL(-1) showed survival rates comparable to PAD patients without diabetes.     

肾移植受者手术前后脂蛋白(a)的变化及其与急性排异的关系

目的观察肾移植受者脂蛋白(a)[Lp(a)]在手术前后的变化以及与急性排斥反应(AR)的发生和肾功能恢复的关系。方法对43例接受同种异体肾移植术患者Lp(a)进行连续监测。结果患者移植前Lp(a)和三酰甘油(TG)显著高于对照组(P<0.01、P<0.05);载脂蛋白A1(ApoA1)显著低于对照组(P<0.01)。术后随时间延长,患者的Lp(a)呈持续性下降趋势,2周降至与对照差异无显著性。但不同组间差异明显。排斥组术前、术后Lp(a)均高于稳定组(P<0.05、P<0.01);而中毒组与稳定组差异无显著性(P>0.05)。在术前Lp(a)≥300mg/L的高Lp(a)患者中有55.6%术后发生AR,明显高于正常Lp(a)水平的患者,差异具有非常显著性(χ2=8.246,P<0.01)。结论肾移植患者术后Lp(a)明显降低,Lp(a)水平与AR之间存在着一定的关联,动态监测肾移植受者手术前后Lp(a)的变化对AR的发生具有提示作用。     

正常孕妇血清脂蛋白(a)含量调查及其临床意义

目的　调查正常孕妇血清脂蛋白 (a) [Lp(a) ]的含量以及在妊娠过程中Lp(a)的变化特征。 方法　采用ELISA法检测2 88例正常孕妇血清Lp(a)含量 ,以 92例非孕年轻女性作对照。同时检测其他血脂指标。 结果　妊娠组和非妊娠组的Lp(a)含量有显著差异 ,分别为 (96 .0± 10 4 .7)mg/L和 (73.8± 83.7)mg/L(P <0 .0 1)。不同妊娠期比较发现中妊组 (2 1～ 2 8周 )和晚妊组 (2 9～ 4 0周 )Lp(a)水平明显高于早妊组 (12～ 2 0周 ) (P <0 .0 5 ) ,约为早妊组的 2倍 ,中妊组和晚妊组Lp(a)水平无差异。其他血脂及载脂蛋白水平随着孕周的增加也显著升高。结论　妊娠期Lp(a)含量的变化可能与孕妇在正常妊娠过程中雌激素水平升高有关 ,是孕妇在妊娠过程中的一种生理需要     

血清总唾液酸测定与活动性类风湿性关节炎的相关性分析

目的 探讨血清总唾液酸（Total sialic　acid;TSA）与活动性类风湿性关节炎的关系。方法用快速单一化学试剂法测定血清中TSA。结果56例活动性类风湿性关节炎患者的TSA水平为812±106mg/L;37例非活动性类风湿性关节炎组TSA水平为672±83mg/L,两组比较有显著性差异（P<0.01）。结论　TSA是推断活动性类风湿性关节炎的生化指标之一,和经典指标联合应用更能反应类风湿性关节性活动的存在。     

急性心肌梗死患者脂蛋白（a）与冠状动脉病变程度的关系

目的探讨急性心肌梗死（AMI）患者血浆脂蛋白（a）[Lp（a）]与冠状动脉病变程度的关系。方法对136例AMI患者进行血脂检测及冠状动脉造影检查,按血浆Lp（a）水平分为低Lp（a）组（〈300 mg/L,46例）和高Lp（a）组（≥300 mg/L,90例）,比较两组血清Lp（a）浓度及冠状动脉病变特点的差异,应用logistic回归分析及逐步回归分析,观察以上指标与冠状动脉狭窄程度的相关性。结果高Lp（a）组Gensini积分、多支病变构成比例、梗死相关动脉（IRA）闭塞率分别为（145.6±36.2）分、58.9%、86.7%,高于低Lp（a）组（96.8±21.7）分、23.9%、56.5%;高Lp（a）组梗死相关动脉心肌梗死溶栓治疗试验（TIMI）积分为（1.58±0.88）分,低于低Lp（a）组的（2.31±1.07）分（P〈0.05）;回归分析发现,Lp（a）是冠状动脉病变程度I、RA闭塞率和TIMI评分的主要影响因素（P〈0.05或〈0.01）。结论 AMI患者血浆Lp（a）水平,与冠状动脉狭窄程度,IRA血流量、闭塞率及密切相关。