新疆维吾尔族人群脂蛋白(a)与冠心病及冠脉狭窄程度的相关性研究

目的探讨新疆巴州地区维吾尔族人群脂蛋白(a)lipoprotein(a),Lp(a)]与冠心病(coronary heart disease,CHD)及冠状动脉狭窄程度之间的相关性。方法采用病例对照研究,选择2007年1月~2011年12月在巴州人民医院住院并行冠状动脉造影检查确诊的维族CHD患者358例;对照组361例,为同期入院行冠状动脉造影检查结果阴性或其他检查排除冠心病者。对所有纳入对象测定禁食12h后静脉血清Lp(a)值及其他生物化学指标,并结合造影情况,探讨高Lp(a)血症与CHD及冠脉病变程度的关系。结果 CHD组高Lp(a)血症的患病率为24.86%,明显高于对照组的14.96%,并具有统计学意义(P=0.007);血Lp(a)水平(217.71±178.69)mg/L显著高于对照组(174.54±146.32)mg/L(P=0.012)。多因素Logistic回归分析显示,在校正了年龄、吸烟、高血压、糖尿病、血脂异常等危险因素作用后发现,高Lp(a)血症是CHD的独立危险因素(OR=1.618,95%CI:1.175~3.419;P=0.013)。CHD组中随着病变支数的增加,高Lp(a)血症的患病率也增加,差异具有统计学意义(P=0.028);血Lp(a)水平也随之增加,差异具有统计学意义(P=0.015)。结论本研究人群高Lp(a)血症是CHD发生的独立危险因素,高Lp(a)血症的患病率及血Lp(a)水平与冠脉狭窄程度呈正相关性,可以作为CHD发病的预测因子。

The association between lipoprotein(a) and coronary artery disease with severity of coronary artery stenosis in Xinjiang Uygur Population

Objective To determine the relationship between lipoprotein(a) and the presence and severity of coronary heart disease(CHD)in Uygur Population from Xinjiang. Methods The study was designed as a case-control study.719 subjects were recruited from Jan 2007 to Dec 2011. The study group consisted of 358 patients with CHD evidenced by coronary arteriography. The control group consisted of 361 subjects without anomaly in coronary arteriography. Serum lipoprotein(a) level and lipid profile, as well as fasting blood glucose, were measured in all patients before the procedure. CHD severity was expressed as a standard analysis of the numbers of coronary arteries that had a stenosis ≥50%. The association between lipoprotein(a) and severity of coronary artery stenosis was analyzed also. Results The prevalence of high lipoprotein(a)was 24.86% in CHD group and 14.96% in control group, there was significant difference between tow groups(P<0.05). The level of serum lipoprotein(a) in CHD group was higher as compared to control group (217.71±178.69) mg/L vs (174.54±146.32) mmol/L(P=0.012). In addition, after adjusting age,gender,diabetes,smoking,dyslipidemia,presence of hypertension and diabetes by multivariate regression analysis, high lipoprotein(a) was an independent risk factor for CHD (OR=1.618,95% CI:1.175~3.419,P=0.013). Along with the increase of the count lesions, the prevalence of high lipoprotein(a) and the level of serum lipoprotein(a) would increase in CHD group, there was significant difference(P>0.05). Conclusion High lipoprotein(a) was an independent risk factor for CHD, the prevalence of high lipoprotein(a)and the level of serum lipoprotein(a) was positively associated with the severity of CHD. It can be used as a predictor of CHD.