老年冠心病患者血清LP(a)、 MPV、 hs-CRP水平与血管内皮功能及冠状动脉病变程度的相关性

Correlation between serum levels of LP(a),MPV and hs-CRP and vascular endothelial function as well as degree of coronary artery lesions in elderly patients with coronary heart disease

中文关键词: 老年    冠心病    脂蛋白(a)    平均血小板体积    高敏C反应蛋白    血管内皮功能    冠状动脉疾病

英文关键词: elderly  coronary heart disease  lipoprotein(a)  mean platelet volume  high sensitivity C-reactive protein  vascular endothelial function  coronary artery disease

中文摘要:

      目的 分析老年冠心病(CHD)患者血清脂蛋白(a)[LP(a)]、平均血小板体积(MPV)、高敏C反应蛋白(hs-CRP)水平与血管内皮功能及冠状动脉病变程度的关系。方法 选择2021年1月至2025年1月中国人民解放军联勤保障部队第九〇一医院心内科收治的130例老年CHD患者作为CHD组，并选择同期的60例体检健康者作为对照组。根据血管内皮功能是否损伤将CHD患者分为损伤亚组(n=82)和非损伤亚组(n=48);根据冠状动脉病变程度分为轻度亚组(n=47)、中度亚组(n=52)和重度亚组(n=31)。比较各组患者血清LP(a)、 MPV、 hs-CRP水平，分析LP(a)、 MPV、 hs-CRP与血管内皮功能及冠状动脉病变程度的关系。结果 CHD组血清LP(a)、 MPV、 hs-CRP高于对照组；和非损伤亚组相比，损伤亚组LP(a)、 MPV、 hs-CRP更高，且LP(a)(r=-0.175)、 MPV(r=-0.390)、 hs-CRP(r=-0.303)与血流介导的舒张功能(FMD值)均为负相关；差异均具有统计学意义(P<0.05)。与轻度亚组和中度亚组比，重度亚组LP(a)、 MPV、 hs-CRP更高，且LP(a)(r=0.301)、 MPV(r=0.630)、 hs-CRP(r=0.486)与Gensini评分均为正相关；差异均具有统计学意义(P<0.05)。多因素分析结果可知，LP(a)、 MPV和hs-CRP水平是老年CHD患者冠状动脉重度狭窄的影响因素，联合预测的AUC为0.901,灵敏度和特异度分别为79.30%和87.50%。结论 血清LP(a)、 MPV、 hs-CRP水平与老年CHD患者血管内皮功能及冠状动脉病变程度有关，临床可用于评估病情进展。

英文摘要:

      Objective To analyze the relationship between the serum levels of lipoprotein(a)[LP(a)],mean platelet volume(MPV)and high-sensitivity C-reactive protein(hs-CRP)and vascular endothelial function as well as the degree of coronary artery lesions in elderly patients with coronary heart disease(CHD).Methods A total of 130 elderly CHD patients admitted to Department of Cardiology,Hospital 901 of Joint Logistics Support Force of Chinese People's Liberation Army from January 2021 to January 2025 were selected as the CHD group,and 60 healthy individuals during the same period were selected as the control group.CHD patients were divided into damaged subgroup(n=82)and non-damaged subgroup(n=48)based on whether vascular endothelial function was damaged;and into mild(n=47),moderate(n=52),and severe(n=31)subgroups based on the degree of coronary artery lesions.The serum levels of LP(a),MPV,and hs-CRP were compared among the groups and subgroups.The relationship between LP(a),MPV and hs-CRP and vascular endothelial function as well as the degree of coronary artery lesions were analyzed.Results The serum levels of LP(a),MPV and hs-CRP in the CHD group were higher than those in the control group.Compared with the non-damaged subgroup,the damaged subgroup had higher serum levels of LP(a),MPV and hs-CRP,and LP(a)(r=-0.175),MPV(r=-0.390)and hs-CRP(r=-0.303)were all negatively correlated with flow-mediated diastolic function(FMD value)(P<0.05).All differences were statistically significant(P<0.05).Compared with the mild and moderate subgroups,the severe subgroup had higher serum levels of LP(a),MPV and hs-CRP,and LP(a)(r=0.301),MPV(r=0.630)and hs-CRP(r=0.486)were all positively correlated with Gensini score.All differences were statistically significant(P<0.05).The results of multivariate analysis showed that the serum levels of LP(a),MPV and hs-CRP were influencing factors for severe coronary artery stenosis in elderly CHD patients,with a combined predictive AUC of 0.901,sensitivity of 79.30%,and specificity of 87.50%.Conclusion The serum levels of LP(a),MPV and hs-CRP are associated with vascular endothelial function and the degree of coronary artery lesions in elderly CHD patients,and can be used clinically to assess disease progression.