Fujino A, Watanabe T, Kunii H, Yamaguchi N, Yoshinari K, Watanabe Y, Mutou M, Ishikawa S, Ogyuu A, Ashikawa K, Maruyama Y
Department of Internal Medicine, Yonezawa City Hospital, Yamagata, Japan.
Jpn Circ J. 2000 Jan;64(1):51-6. doi: 10.1253/jcj.64.51.
Lipoprotein(a) (Lp(a)) is recognized as a new coronary risk factor, but few studies have quantitatively assessed the relationship of serum Lp(a) levels with other coronary risk factors in many patients undergoing coronary cineangiography. Seventeen coronary risk factors were quantified (i.e., age, gender, hypertension, impaired glucose tolerance, cerebrovascular accident, hyperuricemia, smoking, family history of ischemic heart disease (IHD), history of hyperlipidemia, Lp(a), total cholesterol, high density lipoprotein (HDL)-cholesterol, triglyceride, low density lipoprotein-cholesterol, apolipoproteins(apo)A-I,B, E) to determine their relationship with the numbers of involved coronary vessels using multiple regression test in 1,006 patients who underwent coronary cineangiogram (280 non-IHD patients: 144 men, 136 women; 726 IHD patients: 460 men, 266 women; age 16-84 years, mean 60.5+/-0.3). Multiple regression test indicated R = 0.506 and items that showed high beta weight and significant p level were age, Lp(a), impaired glucose tolerance, total cholesterol, cerebrovascular accidents, HDL-cholesterol, smoking, gender, family history of IHD, and apo-A-I (0.221, p<0.001; 0.174, p<0.001; 0.616, p<0.001; 0.138, p<0.001; 0.122, p<0.001; -0.12, p<0.001; 0.092, p<0.01; 0.091, p<0.01; 0.067, p<0.05; -0.065, p<0.05; respectively). It was concluded that Lp(a) is an independent, potential, and modifiable coronary risk factor, and that reduction of serum Lp(a) is important in the clinical management of patients with IHD.
脂蛋白(a)[Lp(a)]被公认为一种新的冠状动脉危险因素,但很少有研究在众多接受冠状动脉造影的患者中定量评估血清Lp(a)水平与其他冠状动脉危险因素之间的关系。对17种冠状动脉危险因素进行了量化(即年龄、性别、高血压、糖耐量受损、脑血管意外、高尿酸血症、吸烟、缺血性心脏病(IHD)家族史、高脂血症病史、Lp(a)、总胆固醇、高密度脂蛋白(HDL)胆固醇、甘油三酯、低密度脂蛋白胆固醇、载脂蛋白(apo)A-I、B、E),以使用多元回归测试确定它们与1006例接受冠状动脉造影患者(280例非IHD患者:144例男性,136例女性;726例IHD患者:460例男性,266例女性;年龄16 - 84岁,平均60.5±0.3)中受累冠状动脉血管数量的关系。多元回归测试表明R = 0.506,显示高β权重和显著p值的因素为年龄、Lp(a)、糖耐量受损、总胆固醇、脑血管意外、HDL胆固醇、吸烟、性别、IHD家族史和apo - A-I(分别为0.221,p<0.001;0.174,p<0.001;0.616,p<0.001;0.138,p<0.001;0.122,p<0.001;-0.12,p<0.001;0.092,p<0.01;0.091,p<0.01;0.067,p<0.05;-0.065,p<0.05)。得出的结论是,Lp(a)是一个独立、潜在且可改变的冠状动脉危险因素,降低血清Lp(a)在IHD患者的临床管理中很重要。