Objective To investigate the assessment value of serum levels of lipoprotein( a) 〔 Lp( a)〕 and NT-proBNP on severity of coronary artery lesion in aged patients(over 65 years old)with coronary heart disease. Methods A total of 342 aged patients(over 65 years old) with discomfort of precordial region were selected in Mining Central Hospital of Feicheng from February 211 to March 2014,and they were divided into A group(with coronary heart disease,n = 246)and B group(without coronary heart disease,n = 96) according to the coronary angiography examination results;according to the number of stenosed coronary arteries,patients of A group were divided into three subgroups:A1 group( with single vessel lesion,n = 67),A2 group(with double - vessel lesions,n = 77)and A3 group(with triple - vessel lesions,n = 102). The severity of coronary artery lesion was quantitatively evaluated by Gensini score,and correlations between serum level of Lp(a), of NT-proBNP and Gensini score were analyzed. Results No statistically significant differences of gender,age,BMI,WHR, SBP,DBP,FPG,TC,TG,LDL or HDL was found between A group and B group(P ﹥ 0. 05),while serum levels of Lp(a) and NT-proBNP of A group were statistically significantly higher than those of B group(P ﹤ 0. 05). Serum levels of Lp(a)and NT-proBNP,and Gensini score of A2 group and A3 group were statistically significantly higher than those of A1 group, meanwhile serum levels of Lp(a) and NT-proBNP,and Gensini score of A3 group were statistically significantly higher than those of A2 group(P ﹤ 0. 05). Pearson correlation analysis results showed that,serum level of Lp( a),of NT-proBNP was positively correlated with Gensini score,respectively( r = 0. 389,0. 585;P ﹤ 0. 05);multivariate linear regression analysis results showed that,number of stenosed coronary arteries,serum level of Lp(a),of NT-proBNP was positively correlated with Gensini score,respectively,39. 1% variation of Gensini score can be explained by the changes of number of stenosed coronary arteries,serum levels of Lp( a) and NT-proBNP. Conclusion Serum levels of Lp( a) and NT-proBNP are positively correlated with the severity of coronary artery lesion in aged patients( over 65 years old) with coronary heart disease,joint detection of serum levels of Lp(a)and NT-proBNP can be used to evaluate the severity of coronary artery lesion.%目的：探讨血清脂蛋白（a）〔Lp（a）〕和 N 末端脑钠肽前体（NT-proBNP）水平对65岁以上冠心病患者冠状动脉病变程度的评估价值。方法选取2011年2月—2014年3月在肥城市矿业中心医院心内科住院治疗的伴有心前区不适的65岁以上老年患者342例，根据冠状动脉造影检查结果分为冠心病组246例和非冠心病组96例，再根据冠状动脉病变支数将冠心病患者分为单支组67例、双支组77例和三支组102例。根据 Gensini 积分定量评估冠状动脉病变程度，并分析血清 Lp（a）和NT-proBNP水平与 Gensini 积分的相关性。结果冠心病组与非冠心病组患者性别、年龄、体质指数、腰臀比、收缩压、舒张压、血糖、总胆固醇、三酰甘油、低密度脂蛋白及高密度脂蛋白比较，差异均无统计学意义（P ﹥0.05）；冠心病组患者血清 Lp（a）和NT-proBNP水平高于非冠心病组（P ﹤0.05）。三支组和双支组患者血清 Lp（a）、NT-proBNP水平及 Gensini 积分高于单支组，三支组患者血清 Lp（a）、NT-proBNP水平及Gensini 积分高于双支组（P ﹤0.05）。Pearson 相关性分析结果显示，血清 Lp（a）、NT-proBNP水平与 Gensini 积分呈正相关（r 值分别为0.389、0.585，P ﹤0.05）；多元线性回归分析结果显示，冠状动脉病变支数、血清 Lp（ a）和NT-proBNP水平与 Gensini 积分呈正相关，且 Gensini 积分变异的39.1%可以由冠状动脉病变支数、血清 Lp（ a）和NT-proBNP水平变化解释。结论血清 Lp（a）和NT-proBNP水平与65岁以上冠心病患者冠状动脉病变程度呈正相关，联合检测血清 Lp（a）和NT-proBNP水平可用于评估患者冠状动脉病变程度。
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