高脂蛋白(a)血症与血浆炎症因子水平和冠状动脉病变程度的关联分析

Association analysis between hyperlipoproteinemia(a) and plasma inflammatory factor levels and the severity of coronary heart disease

摘要:

目的]探索高脂蛋白(a)血症与炎症因子水平和冠状动脉病变程度的相关性。 [方法]将462例接受冠状动脉造影检查的患者根据脂蛋白(a)[Lp(a)]水平分为高Lp(a)组(≥75 nmol/L)和正常Lp(a)组(＜75 nmol/L)。收集患者的临床资料、血脂谱、Gensini评分及12种炎症因子水平。采用Spearman相关分析和Logistic回归模型评估高Lp(a)水平与血浆炎症因子水平及冠状动脉病变程度之间的相关性。 [结果]与正常Lp(a)组相比,高Lp(a)组γ干扰素(IFN-γ)、白细胞介素4(IL-4)和白细胞介素5(IL-5)等9种炎症因子水平显著升高,冠心病和高Gensini评分比例显著增多(P＜0.05)。Spearman相关分析和Logistic回归分析显示,高Lp(a)水平与IFN-γ、IL-4、IL-5、白细胞介素6(IL-6)、白细胞介素12P70(IL-12P70)、白细胞介素1β(IL-1β)、白细胞介素8(IL-8)和肿瘤坏死因子α(TNF-α)水平呈正相关(P＜0.05)。多因素Logistic回归分析显示,高Lp(a)水平是冠心病(OR＝2.483,95%CI:1.548～4.060)和高Gensini评分(OR＝2.102,95%CI:1.332～3.344)的独立危险因素。 [结论]高Lp(a)血症会导致多个炎症因子水平升高,从而增加冠心病发病风险并加重冠状动脉病变程度。

Abstract:

Aim To explore the correlation between hyperlipoproteinemia (a) and levels of inflammatory factors and the severity of coronary artery lesions. Methods A total of 462 patients undergoing coronary angiography were stratified into a high lipoprotein(a)[Lp(a)] group (≥75 nmol/L) and a normal Lp(a) group (＜75 nmol/L). Clinical data, blood lipid profile, Gensini score, and levels of 12 inflammatory factors from patients were collected. Spearman correlation analysis and Logistic regression model were used to evaluate the correlation between high Lp(a) levels and plasma levels of inflammatory factors and the severity of coronary heart disease. Results Compared with the normal Lp(a) group, the high Lp(a) group showed significant increases in the levels of 9 types of inflammatory factors, such as interferon-γ (IFN-γ), interleukin-4 (IL-4) and interleukin-5 (IL-5) (all P＜0.05), as well as a significant increase in the proportion of patients of coronary heart disease and high Gensini scores (both P＜0.05). Spearman correlation analysis and Logistic regression analysis showed that high levels of Lp(a) were positively correlated with levels of IFN-γ, IL-4, IL-5, interleukin-6 (IL-6), interleukin-12P70 (IL-12P70), interleukin-1β (IL-1β), interleukin-8 (IL-8) and tumor necrosis factor-α (TNF-α) (all P＜0.05). Multivariate Logistic regression analysis showed that high levels of Lp(a) were independent risk factors for coronary heart disease (OR＝2.3,5%CI:1.548～4.060) and high Gensini scores (OR＝2.2,5%CI:1.332～3.344). Conclusion Hyperlipoproteinemia(a) can lead to elevated levels of multiple inflammatory factors, thereby increasing the risk of coronary heart disease and worsening the severity of coronary heart disease.