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冠心病合并2型糖尿病患者血浆脂蛋白a水平与冠脉病变的关系

于向东1,万征2   

  1. 1. 天津医科大学总医院心内科
    2. 天津医大总医院心脏科
  • 收稿日期:2011-04-11 修回日期:2011-05-14 出版日期:2011-10-15 发布日期:2011-10-15
  • 通讯作者: 于向东

The Correlation of Lp（a） Levels to the Extent, Severity of Coronary Artery Lesion in Coronary Artery Disease Patients with 2 Type Diabetes Mellitus

YU Xiang-Dong YU Xiang-Dong YU Xiang-Dong 2   

  • Received:2011-04-11 Revised:2011-05-14 Published:2011-10-15 Online:2011-10-15
  • Contact: YU Xiang-Dong YU Xiang-Dong YU Xiang-Dong

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摘要： 摘要 目的：探讨冠心病（CAD）合并2型糖尿病（DM）患者血浆脂蛋白（a）[Lp（a）]水平与冠状动脉（冠脉）狭窄程度与范围之间的关系。方法：163例经冠状动脉造影（CAG）证实CAD的2型DM患者按冠脉狭窄程度分中度（n=19）和重度（n=144）狭窄组，按病变范围分为单支（31例）、双支（48例）、多支（84例）病变组，54例无冠心病患者作为对照组，分别测量和比较各组Lp（a）、总胆固醇（TC）、三酰甘油（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-I（ApoA-I）、载脂蛋白B（ApoB）水平。结果：中、重度狭窄组的Lp（a）水平高于对照组，中度狭窄组与重度狭窄组之间的Lp（a）水无差异。单支、双支、多支病变组Lp（a）水平高于对照组，多支病变组的Lp（a）水平高于单支、双支病变组，组间TC、TG、HDL-C、LDL-C、ApoA-I、ApoB水平差异均无统计学意义。多元回归分析显示Lp（a）水平为冠脉狭窄程度和范围的危险因素。结论：Lp（a）水平可作为2型DM合并CAD患者冠脉病变严重性的评价指标之一。

关键词: 脂蛋白（a）, 冠心病, 2型糖尿病, 冠状动脉造影

Abstract: Abstract Objective: To observe the correlation of lipoprotein(a)[Lp（a）] levels to the extent , severity of coronary artery lesion in coronary artery disease (CAD) patients with 2 type diabetes mellitus. Methods: A total of 163 CAD patients angiographically documented were divided into two groups including moderate stenosis group and severe stenosis group according to severity of coronary artery lesion, divided into three groups including monovessel disease group, bivessel disease group and multivessel disease group according to the extent of coronary artery lesion. 54 subjectswithout CAD as control group. Serum lipid levels （total cholesterol: TC; triglycerides:TG; high-density lipoprotein-cholesterol:HDL-C; low-density lipoprotein -cholesterol:LDL-C; Apolipoprotein A-I : ApoA-I; Apolipoprotein:ApoB） were measured. Results: The Lp（a）levels were significantly higher in moderate stenosis group and severe stenosis group as compared to the controls, and there was no difference between moderate stenosis group and severe stenosis group. The Lp （a） levels were significantly higher in monovessel disease group, bivessel disease group and multivessel disease group as compared to the controls, and higher in multivessel disease group as compared to monovessel disease group and bivessel disease group. No difference of TC, TG, HDL-C, LDL-C, ApoA-I, ApoB levels among moderate stenosis group , severe stenosis group and control group was found , and there was no difference among monovessel disease group, bivessel disease group, multivessel disease group and control group. Logistic regression analysis indicated that Lp（a）levels were independently associated with the extent, severity of coronary artery lesion in Type 2 diabetic patients with CAD. Conclusion: Our data suggest that Lp（a）levels may be helpful in determining the extent, severity of coronary artery lesion in Type 2 diabetic patients with CAD.

Key words: Lipoprotein（a）, Coronary artery disease, 2 type diabetes mellitus, Coronary artery angiography