中国全科医学Issue(6)：666-671,6.DOI:10.3969/j.issn.1007-9572.2016.06.009
脂蛋白（a）与稳定性冠心病的关系及他汀类药物对其水平的影响研究
Relationship Between Lipoprotein(a)Level and Stable Coronary Heart and the Effect of Statins on Lipoprotein(a) Level
摘要
Abstract
Objective To investigate the relationship between lipoprotein(a)〔Lp(a)〕level and stable coronary artery disease ( CAD) and the changing characteristics of Lp ( a) level and other serum lipid parameters after statins therapy. Methods A total of 144 patients were assigned into dyslipidemia group and 99 patients were assigned into stable CAD group;the above patients were definitely diagnosed as conforming to the standard of receiving statins therapy of 2007 Guidelines on Prevention and Treatment of Blood Lipid Abnormality in Chinese Adults and received long - term treatment in Jinyang Community Health Service Center in Shanghai Pudong New Area from April 2011 to January 2014. A total of 136 healthy persons without medical history of hypertension,diabetes and cardiovascular and cerebrovascular diseases and statins treatment were enrolled from the same community as control group using computer random number table. Dyslipidemia group and stable CAD group were given regular treatment with atorvaststin for a year;the level of serum Lp(a)and blood lipid levels of dyslipidemia group and stable CAD group were detected before treatment and after one month,three months and one year treatment;the serum Lp(a)and blood lipid index levels of control group were detected during physical examination and one year later. Results No significant difference existed in gender,age and waist hip ratio among the three groups( P > 0. 05);the body mass index (BMI)of stable CAD group was higher than that of the control group(P < 0. 05);systolic pressure and diastolic blood pressure of dyslipidemia group and stable CAD group were higher than those of control group(P < 0. 05). Lp( a),total cholesterol (TC),low density lipoprotein cholesterin( LDL-C) and triacylglycerol( TG) levels of dyslipidemia group and stable CAD group before treatment were higher than those of control group(P < 0. 05). Lp(a)level of stable CAD group was higher than that of dyslipidemia group(P < 0. 05);TC and LDL-C levels of stable CAD group were lower than those of dyslipidemia group (P < 0. 05);high density lipoprotein cholesterol(HDL-C)level of stable CAD group was lower than that of dyslipidemia group and control group(P < 0. 05). Lp(a)level of control group one year later was not significantly different from the baseline level (P > 0. 05). The comparison of Lp(a)and LDL-C level between dyslipidemia group and stable CAD group before and after treatment showed no interaction effect( P > 0. 05);the comparison of TC,HDL-C and TG levels showed interaction effect between therapeutic method and time(P < 0. 05);significant differences existed in the levels of Lp(a),TC,LDL-C and TG among the three groups(P < 0. 05);significant differences existed in the levels of Lp(a),TC and LDL-C among different time points( P < 0. 05) . Before treatment,Lp( a)level and the levels of TC,LDL-C,HDL-C and TG had no linear correlation in the three groups( | r | < 0. 300);the change of Lp(a)level had no linear correlation with the changes of the levels of TC,LDL-C,HDL-C and TG in the three groups after one - year treatment( | r | < 0. 300). Conclusion Lp(a) level of stable CAD patients is higher than that of dyslipidemia patients and healthy people by physical examination,and Lp(a) level is closely related to CAD;Lp(a)level has no correlation with other serum lipid parameters. The Lp(a)level of patients with stable CAD has no marked decline after statins therapy;the effect of statins on Lp(a)level is undefined.关键词
冠心病/脂蛋白(a)/血脂异常/他汀类药物Key words
Coronary disease/Lipoprotein(a)/Dyslipidemias/Statins分类
医药卫生引用本文复制引用
唐慧芸,王烨,姜盈缨,金丽茵,刁洁华,徐世荣,宋道平..脂蛋白（a）与稳定性冠心病的关系及他汀类药物对其水平的影响研究[J].中国全科医学,2016,(6):666-671,6.基金项目
上海市浦东新区科技发展基金创新资金（ PKWY2012---Y41）；上海市浦东新区系统优秀社区适宜人才培养 （）
