摘要
目的:通过检测血浆D-二聚体(D-dimer,DD)水平以评估不同类型冠心病患者体内新鲜血栓形成的可能性,并研究此类改变与诸血脂指标的相关关系。方法:对124例不类型的冠心病患者与26例正常人分别采用ELISA法测定血浆DD水平和脂蛋白(a)[Lp(a)],酶法测定甘油三酯(TG)、胆固醇(TC)和高密度脂蛋白(HDL),免疫散射比浊法测定载脂蛋白A1(ApoA1)和载脂蛋白B(ApoB)水平。结果:(1)与对照组比较,稳定型心绞痛(SAP)、陈旧性心肌梗死(OMI)组患者DD水平未改变(P>0.05),急性心肌梗死(AMI)组患者DD水平升高非常显著(P<0.01),不稳定型心绞痛(UAP)组患者DD水平亦显著升高(P<0.05),AMI组DD水平显著高于UAP组(P<0.05);与SAP、OMI组比较,UAP、AMI组DD水平升高显著(P<0.05);(2)DD与TG、ApoB和[Lp(a)]呈明显正相关(r=0.393,0.650和0.579,P<0.001);与TC亦呈正相关关系(r=0.235、P=0.009);与ApoA1和HDL呈负相关(r=-0.496,-0.178,P<0.001,P<0.05);(3)多元逐步回归可见ApoB和Lp(a)为独立影响DD的血脂指标。结论:在AMI、UAP组患者中,有与新鲜血栓形成相关指标DD的增高,以AMI组更为严重;血脂异常对冠心病患者的DD水平有影响,其中ApoB和Lp(a)为独立影响DD的血脂指标。
ve: To evaluate the changes of D-dimer (DD) in subjects with stable angina pectoris (SAP), unstable angina pectoris (UAP). old myocardial infarction (OMI) and acute myocardial infarction (AMI), and to explore the relationship between DD and dyslipidemia. Methods: Plasma D-dimer (DD), serum lipoprotein (a) [Lp (a)]. apolipoprotein A1 (Apo A1), apolipoprotein B (Apo B), triglyceride (TG), total cholesterol (TO, high density lipoprotein and low density lipoprotein concentration of 124 cases with coronary heart disease (CHD) and 26 controls were detected respectively by ELISA, immnunoturbidimetry and enzymatic method. Results: (1) Compared with control group. DD levels of OMI and SAP did not change significantly (P<0. 05) . while UAP or AMI had higher DD levels (P<0. 05). and DD levels of AMI were higher than those of UAP (P<0. 05); (2) When linear correlation was used. DD correlated positively with TG (r = 0. 393), Apo B (r=0. 650), Lp (a) (r = 0. 579) (P<0. 001 all) and TC (r = 0. 235. P = 0. 009); DD correlated negatively with Apo A1(r = 0. 496, P<0. 001 ) and HDL (r=0. 178, P <0. 05); (3) Multivariable analysis (stepwise regression) showed that Apo B and Lp (a) were independently associated with DD. Conclusion: Level of DD related fresh thrombogenesis was higher in subjects with UAP or AMI than those in controls, SAP and OMI. The AMI patients were likely associated with more serious thrombogenesis than those with UAP. Apo B and Lp (a) levels were independently correlated with DD.
出处
《心血管康复医学杂志》
CAS
2002年第3期203-206,共4页
Chinese Journal of Cardiovascular Rehabilitation Medicine
