CAJ | 학술논문

目的检测冠心病(CHD)患者的血清脂蛋白(a)和胆红素水平,并探讨其与CHD的关系.方法对196例疑诊冠心病而接受冠状动脉造影的患者检测血清总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、脂蛋白(a)[Lp(a)]、总胆红素(TBIL)、直接胆红素(DBIL)、间接胆红素(IBIL).根据冠状动脉狭窄情况分为非冠心病组(冠状动脉狭窄小于50%,52例)、单支病变组(仅有一支冠状动脉分支狭窄大于或等于50%,53例)和多支病变组(有一支以上冠状动脉分支狭窄大于或等于50%,91例).分析影响冠状动脉病变的相关因素及冠状动脉病变程度与血脂、胆红素的关系.结果各组间LDL-C、Lp(a)水平依次呈递增趋势,差异有统计学意义(P＜0.05)各组间间接胆红素水平呈依次递减趋势,多支病变组与非冠心病组、单支病变组差异有统计学意义(P＜0.05).单因素logistic回归结果表明血清脂蛋白(a)、间接胆红素均为影响冠状动脉病变的因素(回归系数分别2.125、-1.557,P＜0.01).进一步多因素logistic回归分析表明脂蛋白(a)对冠状动脉病变的影响要弱于低密度脂蛋白胆固醇、甘油三酯(0R值分别为1.238、5.031、3.996,95%CI分别为1.069-6.322、2.457-12.356、2.785-14.764).结论血清Lp(a)水平升高、IBIL水平降低是CHD发病及病变程度的危险因素.
목적 검측관심병(CHD)환자적혈청지단백(a)화담홍소수평,병탐토기여CHD적관계.방법 대196례의진관심병이접수관상동맥조영적환자검측혈청총담고순(TC)、감유삼지(TG)、고밀도지단백담고순(HDL-C)、저밀도지단백담고순(LDL-C)、지단백(a)[Lp(a)]、총담홍소(TBIL)、직접담홍소(DBIL)、간접담홍소(IBIL).근거관상동맥협착정황분위비관심병조(관상동맥협착소우50%,52례)、단지병변조(부유일지관상동맥분지협착대우혹등우50%,53례)화다지병변조(유일지이상관상동맥분지협착대우혹등우50%,91례).분석영향관상동맥병변적상관인소급관상동맥병변정도여혈지、담홍소적관계.결과 각조간LDL-C、Lp(a)수평의차정체증추세,차이유통계학의의(P＜0.05)각조간간접담홍소수평정의차체감추세,다지병변조여비관심병조、단지병변조차이유통계학의의(P＜0.05).단인소logistic회귀결과표명혈청지단백(a)、간접담홍소균위영향관상동맥병변적인소(회귀계수분별2.125、-1.557,P＜0.01).진일보다인소logistic회귀분석표명지단백(a)대관상동맥병변적영향요약우저밀도지단백담고순、감유삼지(0R치분별위1.238、5.031、3.996,95%CI분별위1.069-6.322、2.457-12.356、2.785-14.764).결론 혈청Lp(a)수평승고、IBIL수평강저시CHD발병급병변정도적위험인소.
Objective To investigate the association of Lipoprotein (a) and bilirubin with coronary heart disease(CHD). Methods One hundred and ninty -six patients undergone coronary angiography and completed clinical examination of TC, TG, HDL - C, LDL - C, Lp ( a), TBIL, DBIL, IBIL were divided into the without coronary diseases group ( coronary artery stenosis ＜50% ,52 cases) ,the single vessel disease group(with only one vessel stenosis ≥50% ,53 cases) and the multi -vessel disease group (with more than one vessel stenosis ≥50% ,91 cases)according to the coronary angiographic results. The correlative factors of coronary lesion and the relationship between Lipid,bilirubin and the severity of coronary lesion were analyzed. Results Higher levels of LDL - C and Lp(a) were found in the single vessel disease group and in the multi -vessel disease group compared with the without coronary disease group, significant difference was found in the LDL- C and Lp(a) level among the 3 groups(P＜0.05). The levels of IBIL were lower in the single vessel disease group and in the multi -vessel disease group compared with the without coronary disease group,significant difference was found in indirect bilirubin level in the multi -vessel disease group compared with in the without coronary disease group and in the single vessel disease group(P＜0.05). Single factor logistic regression showed that Lp (a) and indirect bilirubin are both correlation factors with coronary lession (r =2. 125 and - 1. 557, P ＜0.01 respectively). Advanced multi - factor logistic regression showed weaker correlation of Lp (a) with coronary lesion compared with LDL - C and TG (OR = 1. 238,5.031 and 3.996,95% CI1.069 - 6.322,2.457 - 12.356,2.785 - 14.764 respectively). Conclusions High level of Lp(a) and Low level of IBIL in human significantly influence the severity of coronary heart disease(CHD).