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脂蛋白(a)是评估不稳定型心绞痛的最佳单项标志物。

Lipoprotein(a) Is the Best Single Marker in Assessing Unstable Angina Pectoris.

机构信息

Institute of Biochemistry, Faculty of Medicine, Niš, Serbia.

出版信息

Cardiol Res Pract. 2011 Mar 7;2011:175363. doi: 10.4061/2011/175363.

Abstract

This study evaluated whether statin therapy changed a diagnostic validity of lipid and inflammatory markers in ischemic heart disease (IHD) patients. Levels of lipids, lipoproteins, apolipoproteins, inflammatory markers, and atherogenic indexes were determined in 49 apparently healthy men and women, 82 patients having stable angina pectoris (SAP), 80 patients with unstable angina (USAP), and 106 patients with acute ST-elevation myocardial infarction (STEMI) treated or not treated with statins. Diagnostic accuracy of markers was determined by ROC curve analysis. Significantly lower apoA-I in all statin-treated groups and significantly higher apoB in statin-treated STEMI group compared to non-statin-treated groups were observed. CRP showed the best ROC characteristics in the assessment of STEMI patients. Lp(a) is better in the evaluation of SAP and USAP patients, considering that Lp(a) showed the highest area under the curve (AUC). Regarding atherogenic indexes, the highest AUC in SAP group was obtained for TG/apoB and in USAP and STEMI patients for TG/HDL-c. Statins lowered total cholesterol, LDL-c, and TG but fail to normalize apoA-I in patients with IHD.

摘要

本研究评估了他汀类药物治疗是否改变了缺血性心脏病(IHD)患者脂质和炎症标志物的诊断有效性。在 49 名貌似健康的男性和女性、82 名稳定性心绞痛(SAP)患者、80 名不稳定型心绞痛(USAP)患者和 106 名急性 ST 段抬高型心肌梗死(STEMI)患者中,测定了脂质、脂蛋白、载脂蛋白、炎症标志物和动脉粥样硬化指数。通过 ROC 曲线分析确定了标志物的诊断准确性。与未接受他汀类药物治疗的组相比,所有接受他汀类药物治疗的组中的载脂蛋白 A-I 水平显著降低,而接受他汀类药物治疗的 STEMI 组中的载脂蛋白 B 水平显著升高。CRP 在评估 STEMI 患者方面表现出最佳的 ROC 特征。考虑到脂蛋白(a)的曲线下面积(AUC)最高,脂蛋白(a)在评估 SAP 和 USAP 患者方面表现更好。关于动脉粥样硬化指数,在 SAP 组中,TG/载脂蛋白 B 的 AUC 最高,而在 USAP 和 STEMI 患者中,TG/高密度脂蛋白胆固醇(HDL-c)的 AUC 最高。他汀类药物降低了 IHD 患者的总胆固醇、低密度脂蛋白胆固醇和甘油三酯,但未能使载脂蛋白 A-I 正常化。

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