高血压患者血清脂蛋白(a)浓度与颈动脉粥样硬化斑块的相关性研究

目的 观察在低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)是否达标的高血压患者中血浆脂蛋白(a)[lipoprotein (a),Lp(a)]的浓度,及其与颈动脉粥样硬化斑块形成的相关性.方法 入选高血压病史5年以上的高血压患者530例,按照LDL-C达标与否进行分层,再将每层按照有无颈动脉斑块进行分组,分为LDL-C达标有斑块组(A组)、LDL-C达标无斑块组(B组)、LDL-C未达标有斑块组(C组)和LDL-C未达标无斑块组(D组),观察各组Lp(a)的浓度.结果 (1)IDL-C达标组患者的Lp(a)浓度低于LDL-C未达标组,其差异有统计学意义(P＜0.01);(2)在LDL-C达标组中,A组患者Lp(a)浓度大于B组,但差异无统计学意义(P＞0.05);在LDL-C未达标组中,C组患者Lp(a)浓度大于D组,差异具有统计学意义(P＜0.01).结论 对于入院时LDL-C已达标的患者,基线Lp(a)浓度与颈动脉粥样硬化斑块发生无明显相关.然而,对于入院时LDL-C未达标的患者,基线Lp(a)浓度升高可能是颈动脉粥样硬化斑块形成的预测因素.

Relationship between the level of lipoprotein(a) and carotid atherosclerotic plaques in patients with high blood pressure

Objective To observe the serum level of lipoprotein(a) in high blood pressure patients with low density lipoprotein cholesterol (LDL-C) standards and its association with carotid atherosclerotic plaques.Methods Five hundred and thirty patients with history of hypertension for over 5 years were recruited for the study.They were stratified by depending on whether or not they reached the LDL-C standards.Then,by depending on whether there was presence of carotid plaques in each layer,they were divided into 4 groups:Group A with LDL-C standards and plaques,Group B with LDL-C standards but without plaques,Group C without LDLC standards but with plaques,Group D without LDL-C standards but without plaques.Close observations were made on the levels of Lp (a) in each groups.Results (1) The Lp (a) levels of the groups with LDL-C standards were lower than those of the groups without LDL-C standards.Statistical significance could be noticed when comparisons were made between them(P ＜ 0.01).(2) In the group with LDL-C standards,the Lp (a) level in the patients of Group A was higher than that in the patients of Group B,but there was no statistical significance when comparisons were made between them (P ＞ 0.05).In the group without LDL-C standards,the Lp (a) level in the patients of Group C was higher than that in the patients of Group D,with statistical significance (P ＜ 0.01).Conclusion For the patients with LDL-C level reaching the required standards at the admission,baseline level of Lp (a) seemed to have no obvious correlation with carotid atherosclerotic plaques.However,for the patients without LDL-C level reaching the required standards at the admission,elevated baseline LDL-C level might be a predicting factor in the formation of carotid atherosclerotic plaques.