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对于因临床怀疑冠状动脉粥样硬化而接受冠状动脉造影的男性患者,血浆脂蛋白(a)[Lp(a)]水平与冠状动脉病变的数量、严重程度及病变长度扩展相关。

Plasma Lp(a) levels correlate with number, severity, and length-extension of coronary lesions in male patients undergoing coronary arteriography for clinically suspected coronary atherosclerosis.

作者信息

Budde T, Fechtrup C, Bösenberg E, Vielhauer C, Enbergs A, Schulte H, Assmann G, Breithardt G

机构信息

Hospital of the Westfälische Wilhelms-University of Münster, FRG.

出版信息

Arterioscler Thromb. 1994 Nov;14(11):1730-6. doi: 10.1161/01.atv.14.11.1730.

DOI:10.1161/01.atv.14.11.1730
PMID:7947596
Abstract

The relation between lipoprotein(a) [Lp(a)] as an independent risk factor for coronary atherosclerosis and the severity and extension of angiographically detectable coronary atherosclerotic lesions has not been systematically evaluated. In 118 male patients (54.3 +/- 7.4 years) with suspected coronary artery disease and without a history of myocardial infarction undergoing coronary angiography, the relation between plasma Lp(a) levels and other lipoproteins and the severity and extension of coronary lesions was studied. The coronary angiograms were evaluated in a blinded manner according to three scores: vessel score (0 to 3 points for 0 to 3 vessels with stenoses > or = 70%), stenosis score (0 to 32 points; number and severity of coronary stenoses or lesions), and extent score (0 to 100 points; length-extension of all coronary lesions in relation to the total coronary vessel length). The score values obtained were analyzed for correlations with age and levels of total cholesterol (6.08 +/- 1.26 mmol/L; mean +/- SD), high-density lipoprotein cholesterol (1.04 +/- 0.33 mmol/L), low-density lipoprotein cholesterol (4.18 +/- 1.15 mmol/L), triglycerides (1.88 +/- 1.37 mmol/L), and Lp(a) in plasma (19.5 +/- 22.6 mg/dL). Bivariate correlation analysis resulted in positive correlations between Lp(a) and vessel score (P < .01), stenosis score (P < .01), and extent score (P < .05). With multivariate analyses, besides Lp(a) plasma level (nl), only patient age showed a significant correlation to all three scores used, whereas none of the lipid parameters correlated significantly with all three scores.

摘要

脂蛋白(a)[Lp(a)]作为冠状动脉粥样硬化的独立危险因素,与血管造影可检测到的冠状动脉粥样硬化病变的严重程度和范围之间的关系尚未得到系统评估。在118例疑似冠心病且无心肌梗死病史的男性患者(54.3±7.4岁)中,进行了冠状动脉造影,研究血浆Lp(a)水平与其他脂蛋白以及冠状动脉病变严重程度和范围之间的关系。根据三个评分对冠状动脉造影进行盲法评估:血管评分(0至3分,对应0至3支血管狭窄≥70%)、狭窄评分(0至32分;冠状动脉狭窄或病变的数量和严重程度)和范围评分(0至100分;所有冠状动脉病变的长度与冠状动脉总长度的关系)。分析所获得的评分值与年龄以及总胆固醇(6.08±1.26 mmol/L;平均值±标准差)、高密度脂蛋白胆固醇(1.04±0.33 mmol/L)、低密度脂蛋白胆固醇(4.18±1.15 mmol/L)、甘油三酯(1.88±1.37 mmol/L)和血浆Lp(a)(19.5±22.6 mg/dL)水平的相关性。双变量相关分析显示Lp(a)与血管评分(P<0.01)、狭窄评分(P<0.01)和范围评分(P<0.05)呈正相关。多变量分析结果显示,除了Lp(a)血浆水平(nl)外,只有患者年龄与所使用的所有三个评分均显示出显著相关性,而脂质参数均与所有三个评分无显著相关性。

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