Maranhão R, Santos R D, Furlaneto C, Graziosi P, Stolf N, Vinagre C, Bocchi E, Belotti G, Jatene A, Pileggi F
Instituto do Coração do Hospital das Clínicas, FMUSP.
Arq Bras Cardiol. 1994 Dec;63(6):465-8.
PURPOSE--To evaluate if the levels of lipoprotein (a) [Lp(a)], apolipoproteins (apo) A1, B and the lipid profile (LP) differ among heart transplantation (HT) patients, with coronary artery disease (CAD) and patients without CAD (NL) and if LP discriminates patients with graft vascular disease (GVD). METHODS--A hundred and seventy patients separated in 3 groups: I) HT [n = 43 46 +/- 15 years, 24 months (median) after transplantation], of these 28 were submitted to serial angiography after the first year of transplantation subgroups with GVD (n = 9) and without GVD (NGVD) (n = 19); II) CAD (n = 72, 48 +/- 6 years); III) NL (n = 45, 50 +/- 6 years). RESULTS--HT presented higher apo A1 levels than CAD and NL (1.5 +/- 0.5 vs 1.2 +/- 0.05 vs 1.1 +/- 0.06 g/l p < 0.05 respectively). Apo B was higher on CAD than in HT and NL (1.5 +/- 0.05 vs 1.2 +/- 0.07 vs 1.3 +/- 0.09 g/l p < 0.05). Lp (a) presented a trend to higher levels in HT and CAD than in NL [25(2-97), 24(1-130) and 15 (1-100) mg/dl, p = 0.05)]. However, when individually evaluated against NL Lp(a) levels were higher in HT and CAD (p = 0.019 and 0.03 respectively). LP did not differ between GVD and NGVD. CONCLUSION--Increased Lp(a) levels after transplantation might be related to the high prevalence of GVD. The LP did not discriminate GVD.
目的——评估心脏移植（HT）患者中，合并冠状动脉疾病（CAD）患者与无CAD患者（NL）的脂蛋白（a）[Lp（a）]、载脂蛋白（apo）A1、B水平及血脂谱（LP）是否存在差异，以及LP能否区分患有移植血管疾病（GVD）的患者。方法——170例患者分为3组：I）HT组[n = 43，年龄46±15岁，移植后24个月（中位数）]，其中28例在移植后第1年接受了系列血管造影检查，分为有GVD亚组（n = 9）和无GVD亚组（NGVD）（n = 19）；II）CAD组（n = 72，年龄48±6岁）；III）NL组（n = 45，年龄50±6岁）。结果——HT组的apo A1水平高于CAD组和NL组（分别为1.5±0.5 vs 1.2±0.05 vs 1.1±0.06 g/l，p < 0.05）。CAD组的apo B水平高于HT组和NL组（1.5±0.05 vs 1.2±0.07 vs 1.3±0.09 g/l，p < 0.05）。HT组和CAD组的Lp（a）水平有高于NL组的趋势[分别为25（2 - 97）、24（1 - 130）和15（1 - 100）mg/dl，p = 0.05]。然而，与NL组单独评估时，HT组和CAD组的Lp（a）水平更高（分别为p = 0.019和0.03）。GVD组和NGVD组的LP无差异。结论——移植后Lp（a）水平升高可能与GVD的高患病率有关。LP不能区分GVD。
