董红志,李曦铭,丛洪良,朱延波,王庆彤.脂蛋白a水平及心脏超声心动图钙化评分与冠心病的相关性[J].中国医学影像技术,2021,37(8):1145~1149
脂蛋白a水平及心脏超声心动图钙化评分与冠心病的相关性
Relationships of lipoproteina level, cardiac echocardiographic calcium score and coronary heart disease
投稿时间:2021-02-23  修订日期:2021-06-29
DOI:10.13929/j.issn.1003-3289.2021.08.006
中文关键词:  冠心病  钙质沉着症  脂蛋白(a)  超声心动描记术
英文关键词:coronary disease  calcinosis  lipoprotein (a)  echocardiography
基金项目:天津市胸科医院院级基金(2018XKC17)。
作者单位E-mail
董红志 天津市胸科医院心内科, 天津 300222  
李曦铭 天津市胸科医院心内科, 天津 300222 ljsunlight@126.com 
丛洪良 天津市胸科医院心内科, 天津 300222  
朱延波 天津市胸科医院超声科, 天津 300222  
王庆彤 天津市胸科医院检验科, 天津 300222  
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中文摘要:
      目的 评价血清脂蛋白a[Lp(a)]水平及心脏超声心动图钙化评分(eCS)与冠心病(CHD)的相关性。方法 纳入229例CHD患者,根据病变累及范围分为单支亚组(n=87)、双支亚组(n=47)及三支亚组(n=95);以同期113名经冠状动脉CT血管造影排除CHD的志愿者作为对照组。比较组间及亚组间基本资料、实验室指标及eCS差异,结合eCS及Lp(a)水平进行风险(低、中、高)分层;采用Logistic多因素回归分析评价各指标与CHD的相关性。结果 CHD组与对照组之间,性别、年龄、吸烟史、糖尿病史、高血压病史、空腹血糖、Lp(a)、高密度脂蛋白、载脂蛋白A及肌酐水平差异均具有统计学意义(P均<0.05)。CHD组eCS ≥ 1分者占比(176/229,76.86%)明显高于对照组(24/113,21.24%),且CHD组各亚组eCS与对照组差异均有统计学意义(P均<0.05)。CHD组各亚组Lp(a)水平均明显高于对照组(P均<0.05)。CHD组与对照组风险分层差异有统计学意义(P<0.05)。Logistic回归分析显示糖尿病史、eCS和/或Lp(a)水平是CHD的独立危险因素。结论 eCS及Lp(a)水平是CHD的独立危险因素,可作为筛查CHD的良好指标。
英文摘要:
      Objective To observe the relationships of lipoproteina (Lp) level, cardiac echocardiographic calcium score (eCS) and coronary heart disease (CHD). Methods A total of 229 CHD patients (CHD group) were enrolled and divided into single branch subgroup (n=87), double branches subgroup (n=47) and three branches subgroup (n=95) according to the involvement degrees of CHD. Meanwhile, 113 volunteers who underwent coronary CT angiography that excluding CHD were taken as controls (control group). The basic data, laboratory indicators and eCS were compared between groups and subgroups. The low, medium and high risk level were defined according to eCS and Lp(a) level. Logistic regression analysis was used to evaluate the correlation between each index and CHD. Results Statistically significant differences of gender, age, smoking history, diabetes history, hypertension history, fasting blood glucose, Lp(a), high density lipoprotein, apolipoprotein A and creatinine levels were found between CHD group and control group (all P<0.05). The proportion of eCS ≥ 1 in CHD group (176/229, 76.86%) was significantly higher than that in control group (24/113, 21.24%), and eCS were significantly different between each subgroup and control group (all P<0.05). The levels of Lp(a) in each subgroup were all significantly higher than that in control group (all P<0.05). The risk levels were statistically different between CHD group and control group (P<0.05). Logistic regression analysis showed that diabetes history, eCS and/or Lp(a) levels were independent risk factors for CHD. Conclusion eCS and Lp(a) level were independent risk factors for CHD, which could be used as good indicators for screening CHD.
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