男性冠状动脉病变和脂蛋白(a)及性激素的关系

目的：研究脂蛋白（a)Lp(a)]与男性冠心病（CHD）患者的冠状动脉病变程度的关系。并探讨内源性性激素对Lp(a)水平的影响。方法：观察129例男性冠状动脉造影患者的Lp(a)、血清总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL－C），低密度脂蛋白胆固醇（LDL－C）、载脂蛋白A、B（apoA,apoB）的浓度，并同时测定患者雌二醇（E2）、睾酮（T）的水平。结果：1．患者的血清Lp(a)水平越高，冠状动脉病变越严重（P＜0．01），2．血清Lp(a)水平与E2、T水平无明显相关，男性CHD患者E2、T水平与冠脉造影正常组间无差异（P＞0．05），结论：血清Lp(a)水平的升高是男性CHD的独立危险因子，也是冠状动脉病变严重程度的一个预测因素，其浓度与内源性性激素水平无关。

Correlation Between Coronary Artery Disease with Lipoprotein(a) and Sex Hormone Levels in Men

Objective To investigate the correlation between the Lp(a) concentration and the severity of coronary heart disease (CHD) in men, and to correlate the effects of endogenous sex hormone levels on serum Lp ( a). Methods One hundred twenty - nine male patients undergoing coronary angiography were enrolled in the study, Lp( a) and serum lipids were measured with usual procedures. Serum estradiol ( E2) and testosterone (T) were determined by radioimmunoassay. Results 1. There was strong relationship between Lp( a) and the severity of coronary artery disease ( P <0. 01 ) ; 2. whereas serum E2 and T had no correlation with Lp(a) concentration. There were no significant differences in the levels of E2 and T between CHD and control subjects (P >0.05). Conclusion Our result indicates that elevated Lp(a) is an independent risk factor for CHD in men, and is a predictor for the severity of CHD. Serum Lp(a) concentrations do not correlate with endogenous sex hormone levels.