脂蛋白(a)及超敏C反应蛋白含量对冠脉病变程度的预测

目的:探讨脂蛋白(a)Lp(a)]及超敏C反应蛋白(hs-CRP)水平对冠状动脉病变程度的预测价值。方法:入选行冠状动脉造影病例580例,根据冠状动脉病变程度分三组:A组(冠脉狭窄≤30%)154例;B组(冠脉狭窄31%～69%)243例;C组(冠脉狭窄≥70%)183例。对Lp(a)及hs-CRP水平与冠状动脉病变程度的相关性进行分析。结果:(1)随冠状动脉病变程度加重,总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白B(ApoB)、Lp(a)及hs-CRP浓度逐渐增加。与A组比较,B组及C组各指标均有显著性增加(P<0.05或<0.01)。与B组比较,C组Lp(a)及hs-CRP有显著性增加(P<0.01);(2)多元逐步回归分析显示,按标准回归系数大小1.415～1.106顺序,相关因素为Lp(a)、hs-CRP、LDL-C和ApoB(P<0.05～<0.01),Lp(a)联合hs-CRP可使OR值进一步增高(P<0.05)。结论:Lp(a)及hs-CRP对冠状动脉病变程度的预测价值并不优于其他血脂指标,联合二者可提高其预测价值。

Predict value of Lipoprotein (a), high-sensitivity C-reactive and their combination on coronary artery disease

Objective:To evaluate the predict value of lipoprotein(a)\Lp(a)\],high-sensitive C-reactive protein(hs-CRP)and their combination on coronary artery stenosis in patients with coronary artery disease.Methods:A total of 580 patients underwent coronary angiography were divided into three groups:group A of 154 cases(stenosis less than 30%),group B of 243 cases(stenosis from 31 to 69%),group C of 183 cases(stenosis>70%).The relationship among Lp(a),hs-CRP and severity of coronary artery disease by angiography were analyzed.Results:(1)Significant statistical differences were found between the three groups for the parameters included total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),apolipoprotein B(Apo B),Lp(a)and hs-CRP(P<0.05,<0.01);Compared with group B,the Lp(a)and hs-CRP significantly increased(P<0.01)in group C;(2)Logistic regression analysis showed that Lp(a)and hs-CRP positively correlate with coronary artery disease(standard regression coefficient 1.415,1.329,P<0.01),Lp(a)combined with hs-CRP would further elevated predicative value(P<0.05).Conclusion:Lp(a)and hs-CRP levels are significant risk determinants for CAD,the predicative value of Lp(a)or hs-CRP is not better than other blood lipids,but concomitant evaluation of Lp(a)and hs-CRP may improve predicative value for CAD.