脂蛋白A与中老年肥胖患者颈部动脉粥样硬化斑块的相关性分析

Correlation between Lipoprotein A and Carotid Atherosclerotic Plaque in Middle-Aged and Elderly Obese Patients

摘要: 目的：探讨脂蛋白A与中老年肥胖患者颈部动脉粥样硬化斑块的相关性。方法：选取青岛市某三甲医院中老年肥胖患者100例纳入观察组，根据颈部血管彩超检查结果，将其分为斑块组(49例)和无斑块组(51例)，再根据颈动脉内斑块回声性质，将斑块组分为稳定斑块亚组(26例)和不稳定斑块亚组(23例)。另选取60例体检健康者作为对照组，取空腹静脉血测定脂蛋白A，比较各组脂蛋白A水平。结果：观察组的脂蛋白A水平高于对照组，差异有统计学意义(P < 0.05)。与无斑块组相比，斑块组的年龄、LP(a)、SBP、TC、TG、LDL-C、FBG水平明显升高，差异均有统计学意义(P < 0.05)。不稳定斑块亚组LP(a)、TC、LDL-C水平高于稳定斑块亚组，差异有统计学意义(P = 0.001, P = 0.027, P = 0.032)。Logistic回归分析显示LP(a)是影响颈动脉粥样硬化斑块的稳定性的危险因素(P < 0.05)。Spearson法分析显示LP(a)水平与IMT检测值呈正相关(P < 0.001)。结论：中老年肥胖患者LP(a)水平呈高表达，其可能与颈动脉粥样硬化发生有关。

Abstract: Objective: To investigate the correlation between lipoprotein A and atherosclerotic plaque in the neck of middle-aged and elderly obese patients. Methods: A total of 100 middle-aged and elderly obese patients from a third-class A hospital in Qingdao were included in the observation group. Ac-cording to the results of cervical vascular color Doppler ultrasound, they were divided into plaque group (49 cases) and no plaque group (51 cases). According to the echo properties of carotid plaques, the plaque group was divided into stable plaque subgroup (26 cases) and unstable plaque subgroup (23 cases). Another 60 healthy subjects were selected as the control group. Fasting ve-nous blood was taken to determine the level of lipoprotein A. Results: The level of lipoprotein A in observation group was higher than that in control group, and the difference was statistically signif-icant (P < 0.05). Compared with the non-plaque group, the levels of age, LP(a), SBP, TC, TG, LDL-C and FBG in the plaque group were significantly increased, with statistical significance (P < 0.05). The levels of LP(a), TC and LDL-C in the unstable plaque subgroup were higher than those in the stable plaque subgroup, and the difference was statistically significant (P = 0.001, P = 0.027, P = 0.032). Logistic regression analysis showed that LP(a) was a risk factor affecting the stability of carotid ath-erosclerotic plaque (P < 0.05). Spearson analysis showed that LP(a) level was positively correlated with IMT (P < 0.001). Conclusion: LP(a) level is highly expressed in middle-aged and elderly obese patients, which may be related to the occurrence of carotid atherosclerosis.