冠心病患者颈动脉硬化与脂蛋白(a)的相关性研究

目的 研究冠心病患者颈动脉硬化与血清脂蛋白(a)的关系。方法 159例冠状动脉造影(CAG)阳性冠心病患者作为试验组，并进行定量Gensini积分，40例CAG正常者作为对照组，行颈动脉超声检测及血清脂蛋白(a)检查。根据颈动脉超声结果将试验组分为内膜正常组（24例），轻度狭窄组(41例)，中度狭窄组（82例），重度狭窄组（12例）。结果 试验组颈动脉硬化检出率为84.9％(135/159)，对照组颈动脉硬化检出率为42.5％(17/40)，两组比较差异有统计学意义(P＜0.01)。内膜正常组与轻度狭窄组Gensini积分比较差异无统计学意义（P＞ 0.05），其他亚组间比较差异均有统计学意义(P＜ 0.05或＜0.01)，其中重度狭窄组与中度狭窄组比较差异有统计学意义(P＜0.01)。试验组脂蛋白(a)总体水平为(35.27±23.38) mg/L，明显高于对照组的(23.13±16.56) mg/L，两组比较差异有统计学意义(P＜0.01)。轻度狭窄组与内膜正常组脂蛋白(a)总体水平比较差异无统计学意义(P＞0.05)，其他亚组间比较差异均有统计学意义(P＜ 0.05或＜0.01)，其中重度狭窄组与中度狭窄组比较差异有统计学意义(P＜0.01)。结论 颈动脉硬化的超声检测有助于预测冠心病的危险程度；血清脂蛋白(a)水平与颈动脉硬化密切相关，在冠心病患者的病情判断上有重要价值。

Relationship between carotid sclerosis and lipoprotein(a) in patients with coronary artery disease

Objective To study the relationship between carotid sclerosis and lipoprotein (LP) (a) in patients with coronary artery disease. Methods One hundred and fifty-nine coronary artery disease patients with coronary arteriongraphy (CAG) positive were selected as the study group, and Gensini points were taken in these patients. Forty CAG normal patients was in control group, and all of them were examined with ultrasound, and serum levels of LP (a) were tested. According to ultrasound, study group were divided into 4 subgroups: normal intima group(24 cases), mild stenosis group(41 cases), moderate stenosis group (82 cases) and severe stenosis group ( 12 cases). Results The rate of carotid sclerosis in study group 84.9％ (135/159)] was significantly higher than that in control group 42.5％ ( 17/40 )] (P ＜ 0.01 ). Gensini points in moderate and severe stenosis group were significantly higher than those in normal intima and mild stenosis group (P ＜ 0.05 or ＜ 0.01 ), Gensini points in severe stenosis group were significantly higher than those in moderately group(P ＜ 0.01 ), but there was no significant difference between mild stenosis group and normal intima group(P ＞ 0.05 ). The level of LP(a) in study group(35.27 + 23.38) mg/L] was significantly higher than that in control group(23.13 ± 16.56) mg/L](P＜ 0.01 ). The level of LP(a) in mild stenosis group was significantly lower than that in moderate and severe stenosis group(P＜ 0.05 or ＜ 0.01 ), and there was no significantly difference compared with that in normal intima group(P＞ 0.05 ). Conclusions Carotid sclerosis ultrasonic testing helps to predict the risk degree of coronary artery disease. The level of LP(a ) is closely related with carotid sclerosis and has important value in judging the condition of patients with coronary artery disease.