Tenda K, Saikawa T, Maeda T, Sato Y, Niwa H, Inoue T, Yonemochi H, Maruyama T, Shimoyama N, Aragaki S
Department of Medicine, Oita Medical University, Japan.
Jpn Circ J. 1993 Aug;57(8):789-95. doi: 10.1253/jcj.57.789.
The purpose of this study was to elucidate the possible link between lipoprotein(a) (Lp(a)) and the occurrence of restenosis after initial elective percutaneous transluminal coronary angioplasty (PTCA). Serum lipids, including Lp(a), total cholesterol, triglyceride, HDL-cholesterol, LDL-cholesterol, apolipoprotein A-I (Apo A-I), and apolipoprotein B (Apo B), and the Apo B/Apo A-I ratio were examined in 63 consecutive patients (41 men and 22 women, average age 63 +/- 8 years) who underwent initial elective PTCA in our department. Forty two target lesions were in left anterior descending, 10 were in left circumflex and 11 were in right coronary branches. Restenosis was observed in 22 patients (35%) 6.4 +/- 2.6 months after PTCA. The serum Lp(a) level was significantly higher in the restenosis group than in the non-restenosis group (38.0 vs 19.9 mg/dl, p < 0.05). A significant correlation was observed between serum Lp(a) levels and the degree of % restenosis after PTCA (r = 0.557, p < 0.001). However, other lipids showed no significant relationship to restenosis. In addition, the % stenosis before PTCA was found to be related to the occurrence of restenosis after successful PTCA. We conclude that the serum Lp(a) level has a close correlation with the degree of % restenosis after PTCA, and may be a useful index for predicting the possibility of restenosis after PTCA, especially in patients with an Lp(a) level above 30 mg/dl.
本研究的目的是阐明脂蛋白(a)[Lp(a)]与初次选择性经皮腔内冠状动脉成形术(PTCA)后再狭窄发生之间的可能联系。对在我科接受初次选择性PTCA的63例连续患者（41例男性和22例女性，平均年龄63±8岁）检测了血清脂质，包括Lp(a)、总胆固醇、甘油三酯、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、载脂蛋白A-I(Apo A-I)和载脂蛋白B(Apo B)，以及Apo B/Apo A-I比值。42个靶病变位于左前降支，10个位于左旋支，11个位于右冠状动脉分支。PTCA后6.4±2.6个月，22例患者(35%)出现再狭窄。再狭窄组的血清Lp(a)水平显著高于无再狭窄组(38.0对19.9mg/dl，p<0.05)。观察到血清Lp(a)水平与PTCA后再狭窄百分比程度之间存在显著相关性(r=0.557，p<0.001)。然而，其他脂质与再狭窄无显著关系。此外，发现PTCA前的狭窄百分比与成功PTCA后再狭窄的发生有关。我们得出结论，血清Lp(a)水平与PTCA后再狭窄百分比程度密切相关，可能是预测PTCA后再狭窄可能性的有用指标，尤其是Lp(a)水平高于30mg/dl的患者。
