冠心病患者血脂和D-二聚体水平的临床意义

目的探讨血脂和D-二聚体(DD)水平与不同类型冠心病的关系。方法对209例不同类型的冠心病患者和25例正常人分别采用ELISA法测定血浆DD水平和脂蛋白(a)LP(a)],酶法测定三酰甘油(TG)、胆固醇(TC)、低密度脂蛋白(LDL)和高密度脂蛋白(HDL),免疫散射比浊法测定载脂蛋白A(ApoA)和载脂蛋白B(ApoB)水平。结果(1)不同类型的冠心病在性别、年龄、体质量、吸烟史、高血压史、糖尿病史差异无统计学意义。(2)与对照组比较,稳定型心绞痛(SAP),陈旧性心肌梗死(OM I)组患者DD水平未见明显改变(P>0.05),急性心肌梗死(AM I)组患者DD水平升高非常显著(P<0.01),不稳定型心绞痛(UAP)组患者DD水平亦显著升高(P<0.05),AM I组DD水平显著高于UAP组(P<0.05);与SAP,OM I组比较,UAP,AM I组DD水平升高显著(P<0.05);(3)不同类型CHD组与对照组在TG、TC、LDL、HDL、ApoA、ApoB、Lp(a)与CHD组相比均差异有统计学意义(P<0.05、P<0.01)。SAP、OM I与UAP、AM I在TG、HDL、ApoB、LP(a)方面差异有统计学意义(P<0.05、P<0.01)。结论在AM I、UAP组患者中,与新鲜血栓形成相关指标DD的增高,以AM I组更为严重,并且TC、ApoB、Lp(a)也明显升高。

A study on the changes of serum lipid and D-dimer levels in patients with coronary disease

Objective To explore blood fat and DD Levels of coronary patients and their relations with different types of coronary diseases. Methods Samples were taken from 209 patients with CHD and 25 healthy people and a series of studies were conducted,such as as the test of blood fat D-dimer（DD） Levels and tipoprotein LP （a） ] by ELISA, TG, TC, LDL and HDL by enzymatic analysis, and ApoA and ApoB by immunoradio-metric assay. Results （ 1 ） No obvious statistic difference was found among different types of comorary patients in regard to gender, age, weight, history of smoking, history of high blood pressure, as well as that of diabetes. （2） Compared with the contrasting group,no obvious changes were found in the D-dimer level with SPA and OMI group（ P 〉 0.05）. While the D-dimer levei raised obviously in AMI group（P 〈0.01 ）. Also DD level was found to raise high in UAP group （ P 〈 0. 05）. Of the two groups, the D-dimer level of AMI group obviously higher than that of UAP group （P 〈 0. 05 ）. Compared with SAP and OMI groups, the DD level in UAP ang AMI groups was obviously higher （P 〈 0. 05, P 〈 0. 01 ）. （3） Obvious difference were found between different types of CHD groups and contrasting group in serum TG, TC, LDL, HDL, ApoA, ApoB levels, as well as LP （a） （ P 〈 0. 05, P 〈 0. 01 ）. Difference were also found to exist among SAP,OMI groups and UAP and AMI in serum TG,HDL,ApoB,andLP（a） levels （P 〈0. 05 ,P 〈0. 01 ）. Conclusion In AMI and UAP patients,the DD level related with fresh thrombophil raise high, with AMI most sever, and their TC,ApoB and LP（a） also raise high.