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目的 探讨脂蛋白 a与主动脉夹层瘤的关系。方法 以诊断明确的 2 7例急性主动脉夹层瘤患者为研究对象 ,以同期年龄、性别构成相近的急性心肌梗死患者 6 0例、健康人群 5 0例为对照 ,分析他们的血脂蛋白 a[LP(a) ]、C 反应蛋白 (CRP)及白细胞 (WBC)计数水平 ,并比较。观察其中 8例主动脉夹层瘤患者发病后 2 4、72h、5dLP(a)、CRP、白细胞计数的动态变化。结果 ①主动脉夹层瘤组、急性心肌梗死对照组、健康对照组血清平均LP(a)浓度分别为 (32 7.35± 89.2 3)、(2 6 1.35± 77.5 4 )、(79.6 9±2 1.6 3)mg L ,3组间差别均有统计学意义 (P <0 .0 5 ) ;②主动脉夹层瘤组和急性心肌梗死对照组患者血平均CRP水平分别为 (12 .12± 6 .15 )、(10 .31± 8.33)mg dl,白细胞计数分别为 (11.0 6± 4 .2 )× 10 9 L、(10 .38± 5 .6 )× 10 9 L ,均高于健康对照组 (P <0 .0 1) ;但前两组患者间CRP、白细胞计数比较无统计学意义 (P >0 .0 5 ) ;③主动脉夹层瘤发病后 72h内LP(a)、CRP水平和白细胞水平均呈持续性升高 ,入院后第5天CRP、白细胞水平明显下降 ,LP(a)仍处于较高水平。结论 急性主动脉夹层瘤患者血清LP(a)水平明显升高 ,可能与其促炎症反应有关
Objective To investigate the relationship between lipoprotein a and aortic dissection. Methods Twenty-seven patients with acute aortic dissecting aneurysm were enrolled in this study. Sixty patients with acute myocardial infarction with similar age and gender composition and 50 healthy controls were included in this study. Their levels of serum lipoprotein a [LP (a)], C-reactive protein (CRP) and white blood cell (WBC) count levels, and compared. The dynamic changes of LPL (a), CRP and leukocyte count at 2, 4, 72h, 5d after onset were observed in 8 patients with aortic dissection. Results ① The mean LP (a) concentrations in aortic dissection group, acute myocardial infarction control group and healthy control group were (32 7.35 ± 89.2 3), (26.335 ± 77.54) and (79.6 9 ± 2 1.6 3 ) mg L, the differences among the three groups were statistically significant (P <0.05). ② The mean CRP levels in patients with aortic dissection group and acute myocardial infarction control group were (12.12 ± 6.15) , (10.31 ± 8.33) mg dl respectively, and the white blood cell counts were (11.0 6 ± 4. 2) × 10 9 L and (10 38 ± 5 6) × 10 9 L respectively (P <0.05) .③The level of LP (a), CRP and the level of leukocyte in the first 72 hours after the onset of aortic dissection (P> 0.05) Showed a persistent increase in admission on the 5th day of CRP, leukocyte levels decreased significantly, LP (a) is still at a high level. Conclusions The level of serum LP (a) in patients with acute aortic dissection is significantly increased, which may be related to its proinflammatory response