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目的:探讨脂蛋白(a)[Lp(a)]水平在青年急性心肌梗死(AMI)患者中的变化及其与凝血指标的关系。方法:对32例青年AMI患者、30例青年冠心病(CHD)患者及36例正常对照者进行冠状动脉(冠脉)造影术,并检测其血中Lp(a)、D-二聚体(D-D)、纤溶酶原活性(Pig)、抗凝血酶原(AT-Ⅲ)及组织纤溶酶原激活物(t-PA)的水平。结果:①AMI组和CHD组Lp(a)明显高于正常对照组[(230±60)和(190±20):(110±20)mg/L,P<0.05],但前两组之间差异无显著性意义(P>0.05);②高Lp(a)血症患者AMI的发生率明显高于血清Lp(a)正常的患者(47％:15％,P<0.01);③AMI组D-D明显高于CHD组和正常对照组(12±5):(4±3)mg/L和(2±1)mg/L,P<0.01);④冠脉多支病变者Lp(a)的水平明显高于单支病变者(P<0.01)。结论:青年AMI患者中存在Lp(a)水平增高,并与D-D水平及冠脉病变支数呈正相关。
Objective: To investigate the changes of lipoprotein (a) [Lp (a)] in young patients with acute myocardial infarction (AMI) and its relationship with coagulation parameters. Methods: Coronary (angiography) was performed in 32 young patients with AMI, 30 young patients with coronary heart disease (CHD) and 36 normal controls. The levels of Lp (a), D-dimer DD), plasminogen activator (Pig), antithrombin (AT-III) and tissue plasminogen activator (t-PA). Results: ① Lp (a) in AMI group and CHD group was significantly higher than that in control group [(230 ± 60) and (190 ± 20) :( 110 ± 20) mg / L, P <0.05] (P> 0.05). ② The incidence of AMI in patients with high Lp (a) was significantly higher than that in patients with normal serum Lp (a) (47% vs 15%, P <0.01) (4 ± 3) mg / L and (2 ± 1) mg / L, respectively) in CHD group and normal control group (P <0.01) The level was significantly higher than those with single vessel disease (P <0.01). Conclusions: There is an increase of Lp (a) in young AMI patients, which is positively correlated with D-D level and the number of coronary lesions.