Objective To evaluate the correlation between the level of serum lipoprotein (a) [ LP (a) ] and the short-term prognosis in acute coronary syndrome (ACS) . Methods Totally 228 ACS inpatients were recruited including 107 a-cute myocardial infarction (AMI) and 121 unstable angina pectoris (UAP). And 92 inpatients with stable angina pectoris (SAP) were in the corresponding period selected. The levels of LP (a), blood lipid and the prevalence of major adverse cardiac events (MACE) were compared among all the groups, and the correlation between the LP (a) and the short-term prognosis was analyzed. Results (1) The LP (a) levels of the AMI, UAP and SAP groups were respectively (365. 5 ± 74. 8) mg/L, (348. 6 ± 69. 4) mg/L and (279. 0 ± 38. 8) mg/L, with a statistically significant difference (F =49. 760, P <0. 05). (2) The prevalence rates of MACE in the AMI, UAP and SAP groups were 39. 25% , 41. 32% , and 7. 61% , respectively, with a statistically significant difference (X2 =33. 004, P <0. 05). (3) The multi-vessel disease rate and MACE rate in the group with IP (a) level ≥ 300 mg/L were 88. 32% and 43. 65% , being statistically higher than 35. 48% and 19. 35% in the group with IP (a) <300 mg/L (P <0. 05) . Conclusion The ACS patients have disturbed metabolism of blood lipid. The level of IP (a) is remarkably increased as compared with SAP patients, which is associated with the severity of coronary lesions and the short-term prognosis of ACS.%目的 探讨脂蛋白(a)[LP(a)]水平与急性冠脉综合征(ACS)患者近期预后的相关性.方法 选取228例ACS患者,分为急性心肌梗死(AMI)亚组107例和不稳定型心绞痛(UAP)亚组121例;选取同期住院的92例稳定型心绞痛(SAP)患者为SAP组.比较各组LP(a)水平、血脂水平及主要心脏不良事件(MACE)发生率,分析LP(a)水平与ACS患者近期预后的相关性.结果 (1)AMI亚组、UAP亚组、SAP组的LP(a)水平分别为(365.5±74.8)mg/L、(348.6±69.4)mg/L、(279.0±38.8)mg/L,三组间的LP(a)水平比较,差异有统计学意义(F=49.760,P＜0.05).(2)AMI亚组、UAP亚组、SAP组的MACE发生率分别为39.25%、41.32%、7.61%,三组间的MACE发生率比较,差异有统计学意义(χ2=33.004,P＜0.05).(3)LP(a)水平≥300 mg/L组的多支病变率和MACE发生率(分别为88.32%、43.65%)高于LP(a)水平<300 mg/L组(分别为35.48%、19.35%),差异均有统计学意义(P＜0.05).结论 ACS患者存在血脂代谢紊乱,LP(a)水平较SAP患者明显升高;LP(a)水平可能与冠脉病变程度和ACS患者的近期预后相关.
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