低密度脂蛋白-胆固醇达标的冠心病患者脂蛋白(a)水平与冠脉病变复杂程度的相关性研究

目的:探讨低密度脂蛋白-胆固醇达标的冠心病患者脂蛋白（a）水平与冠脉病变复杂程度的相关性。方法:收集低密度脂蛋白-胆固醇已达标的212例行冠脉造影的冠心病患者临床资料，根据SYNTAX评分将患者分为低危组（0～22分）104例和中高危组（≥23分）108例，采用Pearson相关分析血脂指标与SYNTAX评分的相关性，绘制ROC曲线评估脂蛋白（a）对冠脉病变复杂程度的预测价值并确定最佳临界值。采用多因素Logistic回归分析脂蛋白（a）与冠脉病变复杂程度的关系。结果:中高危组脂蛋白（a）水平高于低危组28.55（13.98，52.00）nmol/L vs.13.55（8.10，33.60）nmol/L（P <0.01）]。Pearson相关分析显示，脂蛋白（a）水平与SYNTAX评分呈正相关（r =0.235，P <0.01）。ROC曲线显示，脂蛋白（a）预测冠状动脉病变复杂程度的曲线下面积为0.653（95%CI:0.580~0.727，P<0.01），最佳临界值12.70 nmol/L，灵敏度78.7%，特异度49%。多因素Logistic回归分析结果显示，脂蛋白（a）是冠脉病变复杂程度的独立危险因素（OR=2.734，95%CI:1.358~5.504，P <0.01）。结论:低密度脂蛋白-胆固醇达标的冠心病患者中脂蛋白（a）是冠状动脉病变复杂程度的独立危险因素，为冠心病药物治疗提供了新靶点。

Association between coronary anatomical complexity and lipoprotein(a) level in coronary heart disease patients with qualified low-density lipoprotein cholesterol level

Objective: To investigate the association between coronary anatomical complexity and lipoprotein(a) level in coronary heart disease patients with qualified low-density lipoprotein cholesterol level. Methods: The clinical data of 212 coronary heart disease patients undergoing coronary angiography who had qualified low-density lipoprotein cholesterol level were collected. According to the SYNTAX score，the patients were divided into two groups:104 in low-risk group (0-22) and 108 in middle-high risk group (≥23). Pearson correlation analysis was used to analyze the correlation between lipid profile and SYNTAX score. ROC curve was drawn to evaluate the predictive value of lipoprotein(a) for coronary anatomical complexity and determine the optimum critical value. Multivariate Logistic regression was used to analyze the relationship between coronary anatomical complexity and lipoprotein(a) level. Results: The level of lipoprotein(a) in the middle-high risk group was higher than that in the low risk group 28.55(13.98，52.00)nmol/L vs.13.55(8.10，33.60) nmol/L，P <0.01]. Pearson correlation analysis results showed that the level of lipoprotein(a) was positively correlated with SYNTAX score(r =0.235，P <0.01). ROC curve showed that the AUC of lipoprotein(a) in predicting the coronary anatomical complexity was 0.653(95%CI: 0.580-0.727，P <0.01). The optimum critical value was 12.70 nmol/L，the sensitivity was 78.7% and the specificity was 49%. Multivariate Logistic regression analysis showed that lipoprotein(a) was an independent risk factor for coronary anatomical complexity (OR=2.734，95% CI:1.358-5.504，P<0.01). Conclusion: Lipoprotein(a) is an independent risk factor for coronary anatomical complexity in coronary heart disease patients with qualified low-density lipoprotein cholesterol level, and provides a new target for treatment of coronary heart disease.