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目的探讨血脂和D-二聚体(DD)水平与不同类型冠心病的关系。方法对209例不同类型的冠心病患者和25例正常人分别采用ELISA法测定血浆DD水平和脂蛋白(a)[LP(a)],酶法测定三酰甘油(TG)、胆固醇(TC)、低密度脂蛋白(LDL)和高密度脂蛋白(HDL),免疫散射比浊法测定载脂蛋白A(ApoA)和载脂蛋白B(ApoB)水平。结果(1)不同类型的冠心病在性别、年龄、体质量、吸烟史、高血压史、糖尿病史差异无统计学意义。(2)与对照组比较,稳定型心绞痛(SAP),陈旧性心肌梗死(OM I)组患者DD水平未见明显改变(P>0.05),急性心肌梗死(AM I)组患者DD水平升高非常显著(P<0.01),不稳定型心绞痛(UAP)组患者DD水平亦显著升高(P<0.05),AM I组DD水平显著高于UAP组(P<0.05);与SAP,OM I组比较,UAP,AM I组DD水平升高显著(P<0.05);(3)不同类型CHD组与对照组在TG、TC、LDL、HDL、ApoA、ApoB、Lp(a)与CHD组相比均差异有统计学意义(P<0.05、P<0.01)。SAP、OM I与UAP、AM I在TG、HDL、ApoB、LP(a)方面差异有统计学意义(P<0.05、P<0.01)。结论在AM I、UAP组患者中,与新鲜血栓形成相关指标DD的增高,以AM I组更为严重,并且TC、ApoB、Lp(a)也明显升高。
Objective To investigate the relationship between serum lipid and D-dimer (DD) levels and different types of coronary heart disease. Methods Serum DD levels and lipoprotein (a) [LP (a)] were measured by ELISA in 209 patients with different types of coronary heart disease and 25 normal subjects. The levels of triglyceride (TG), cholesterol (TC) , Low density lipoprotein (LDL) and high density lipoprotein (HDL), and the levels of apolipoprotein A (ApoA) and apolipoprotein B (ApoB) by immunoturbidimetry. Results (1) Different types of coronary heart disease had no significant difference in gender, age, body weight, smoking history, history of hypertension and history of diabetes mellitus. (2) Compared with the control group, there was no significant change in DD level in patients with stable angina pectoris (SAP) or in patients with old myocardial infarction (OM I) (P> 0.05). DD levels in patients with acute myocardial infarction (AMI) (P <0.05). The level of DD in AMI group was significantly higher than that in UAP group (P <0.05), while the level of DD in SAP group was significantly higher than that in UAP group (P <0.05). (3) The levels of TG, TC, LDL, HDL, ApoA, ApoB, Lp (a) and CHD in different types of CHD group were higher than those in control group The differences were statistically significant (P <0.05, P <0.01). There were significant differences in TG, HDL, ApoB and LP (a) between SAP, OM I, UAP and AM I (P <0.05, P <0.01). Conclusions In AM I and UAP patients, the index of fresh thrombosis, DD, is more severe in AMI group, and the levels of TC, ApoB and Lp (a) are also obviously increased.