摘要
评价脂蛋白 (a)及其联合其他血脂指标对冠心病的诊断价值。分析 5 4 6例怀疑冠心病患者 (其中经冠状动脉造影确诊的冠心病 35 4例 ,非冠心病 192例 )的临床资料 ,用标准方法检测血脂水平 ,比较各个血脂指标的诊断价值。结果发现 ,冠心病患者血清总胆固醇、低密度脂蛋白胆固醇、脂蛋白 (a)水平及总胆固醇与高密度脂蛋白胆固醇比值显著高于非冠心病患者 ,高密度脂蛋白胆固醇水平明显低于非冠心病患者 ,而两组间其他血脂水平无显著性差异。冠心病患者血清总胆固醇、低密度脂蛋白胆固醇、脂蛋白 (a)及总胆固醇与高密度脂蛋白胆固醇比值的异常率显著高于非冠心病患者 ,其他血脂指标的异常率在两组无明显差别。脂蛋白 (a)对冠心病的预测值及似然比并不优于其他血脂指标 ,联合低密度脂蛋白胆固醇可提高阳性预测值及似然比。在Logstic多元回归中 ,冠心病的危险性与传统的危险因素均呈正相关 ,脂蛋白 (a)与冠心病的相关性不优于其他指标 ,甘油三酯及高密度脂蛋白胆固醇未进入回归模型。结果提示 ,脂蛋白 (a)对冠心病的预测价值并不优于其他血脂指标 。
Aim To evaluate the diagnostic value of serum lipids, lipoprotein (a) and their combination in coronary heart disease (CHD). Methods 546 patients with suspected CHD were enrolled into this study and divided into CHD group (n=354) and non-CHD group (n=192) according to the result of coronary arterography. Their clinical data were analysed by case-control method, and serum lipids were detected by standard method. Results Compared with non-CHD group, the levels of serum total cholesterol, low density lipoprotein cholesterol, lipoprotein (a) and the ratio of total cholesterol to high density lipoprotein cholesterol in CHD group were significantly raised, whereas the level of high density lipoprotein cholesterol were significantly lowered. There was no significant difference in serum triglyceride level and triglyceride/high density lipoprotein cholesterol ratio between two groups. The abnormal rate of total cholesterol, low density lipoprotein cholesterol, total cholesterol/high density lipoprotein cholesterol ratio and lipoprotein (a) in CHD group significantly increased, while the abnormal rate of other lipids didn't show significant difference. The predicative value and likelihood ratio of lipoprotein (a) for CHD was not superior to that of other lipids, but when combined with low density lipoprotein cholesterol, these value would further be elevated. In logistic regression model, lipoprotein (a) wasn't more related to CHD risk than other lipids. Conclusion The diagnostic value of lipoprotein (a) isn't better than other lipids. When combined with low density lipoprotein cholesterol, it may be regarded as a better predicative marker for CHD.
出处
《中国动脉硬化杂志》
CAS
CSCD
2004年第5期589-592,共4页
Chinese Journal of Arteriosclerosis
