维吾尔族老年急性冠状动脉综合征患者视黄醇结合蛋白4、脂蛋白a水平与冠状动脉病变程度的相关性

摘要

目的 探讨新疆地区维吾尔族老年急性冠状动脉综合征(ACS)患者视黄醇结合蛋白4、脂蛋白a水平与冠状动脉病变严重程度的关系.方法 回顾性分析2013年1月～2016年12月在新疆维吾尔自治区人民医院住院行冠脉造影且年龄≥65岁的220例维吾尔族患者的临床资料,根据临床诊断标准分为维吾尔族老年ACS组(150例)和维吾尔族老年非ACS组(70例).根据Gensini评分将ACS患者分为低分组(0～29分)45例、中分组(30～59分)44例、高分组(≥60分)61例,比较各组视黄醇结合蛋白4、脂蛋白a水平以及分析其与Gensini评分的相关性.结果 维吾尔族老年ACS组Gensini评分、视黄醇结合蛋白4、脂蛋白a水平高于维吾尔族老年非ACS组.随着Gensini评分增加,维吾尔族老年ACS患者视黄醇结合蛋白4、脂蛋白a水平升高.Gensini评分与视黄醇结合蛋白4、脂蛋白a水平呈正相关(r=0.501、0.704,均P=0.000).Logistic回归分析提示高视黄醇结合蛋白4、脂蛋白a水平是维吾尔族老年高Gensini评分的独立危险因素.结论 维吾尔族老年ACS患者视黄醇结合蛋白4、脂蛋白a水平升高与冠状动脉病变严重程度相关,是冠状动脉病变程度加重的危险因素.在临床工作中,对维吾尔族老年ACS患者进行上述指标的检测,并对其进行早期干预治疗,对预防急性冠状动脉事件的发生具有重要临床意义.%Objective To investigate the relationship between the levels of retinol binding protein 4,lipoprotein (a) and the severity of coronary artery disease in Uygur elderly patients of acute coronary syndrome (ACS).Methods From January 2013 to December 2016,220 cases of Uygur elderly patients underwent coronary angiography and ≥ 65 years old were retrospectively analyzed and divided into Uygur elderly ACS group (150 cases) and non ACS group (70 cases) according to the clinical diagnostic criteria.Patients in the Uygur elderly ACS group were divided into low-scored groups (45 cases,0-29),middle-scored group(44 cases,30-59) and high-scored group(61 cases,≥60)according to the Gensini score.The retinol binding protein 4 and lipoprotein(a)levels were compared between the Uygur elderly ACS group and non ACS group.The correlation between retinol binding protein 4,lipoprotein (a) and the Gensini score were analyzed.Results The Gensini score,retinol binding protein 4 and lipo-protein (a) in the Uygur elderly ACS group were higher than those of non ACS group.The retinol binding protein 4 and lipoprotein (a) level were increased with the increasing of Gensini score.The Gensini score was positively correlated with the level of retinol binding protein 4 and lipoprotein(a)(r =0.501、0.704,all P =0.000).Logistic regression analysis showed that high retinol binding protein 4 and lipoprotein (a) levels were the independent risk factors of high Gensini scores in Uygur elderly patients.Conclusion The elevated levels of retinol binding protein 4.and lipoprotein (a) are associated with the severity of coronary artery disease and those are risk factors for the aggrava tion of coronary artery disease.In clinical work,the indicators of retinol binding protein 4 and lipoprotein (a) should be detected in Uygur elderly patients of ACS and early prevention should be carried out and that have important clinical significances for Uygur elderly patients of ACS.