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脂蛋白 (a) 作为人造心脏膜血栓形成的危险因素

Mahmut Yesin¹, Macit Kalçık², Emrah Bayam³

¹Department of Cardiology, VM Medicalpark Hospital, Ovacık, D100 Üstü No:34, 41140, Başiskele, Kocaeli, Turkey. mahmutyesin@yahoo.com.

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概括

在患有机械假体栓血栓症 (MPVT) 的患者中,升高的脂蛋白 (a) [Lp(a) ]水平显著更高. 这一发现表明Lp(a) 可能是MPVT和脑血管事故 (CVA) 的独立预测因子.

科学领域:

心血管医学心血管医学
临床化学临床化学
血栓形成研究研究

背景情况:

脂蛋白 (a) [Lp(a) ]是已知的动脉血性疾病的风险因素.
Lp (a) 与等离子体具有结构上的相似性,可能会损害纤维素分解并促进血栓形成.
升高的Lp (a) 与各种心血管疾病有关.

研究的目的:

为了研究和比较机械假发栓血栓症 (MPVT) 患者与对照者的脂蛋白 (a) [Lp(a) ]水平.
确定MPVT的独立预测因素,包括Lp (a) 水平.
探索Lp(a) 水平与MPVT患者脑血管事故 (CVA) 史之间的关联.

主要方法:

一项涉及80名MPVT患者和75名年龄/性别匹配的对照组,具有正常运行的机械假体门的横截面研究.
收集了血样本以确定脂蛋白 (a) [Lp(a) ] 水平.
进行了统计分析,以比较Lp(a) 水平,并确定MPVT的独立预测因子,包括后勤回归和ROC曲线分析.

主要成果:

与对照组相比,患有MPVT的患者表现出明显更高的Lp(a) 水平 (22vs6.9 mg/dL,p<0.001).
升高的Lp(a),次疗法抗凝剂,先前的CVA和较低的国际正常化比率是MPVT的独立预测因素.
在19.6 mg/dL以上的Lp (a) 水平预测了MPVT,其灵敏度为65%,特异性为71% (AUC:0.767).
患有心血管病史的MPVT患者的Lp (a) 水平显著更高 (42.0对21.1 mg/dL,p=0.012).

结论:

升高的脂蛋白 (a) [Lp(a) ]水平与机械假体栓栓塞 (MPVT) 有显著的关联.
血Lp (a) 可能作为MPVT和相关脑血管事件 (CVA) 的独立预测因子.
在患有假心的患者中测量Lp (a) 可能为PVT和CVA提供有价值的风险分层.

关键词:

脂蛋白 (a) 是一种蛋白质.假肢心脏门假肢心脏门血栓形成的原因之一是血栓形成.通过食道的心声回声学 (Transesophageal echocardiography) 是一种心声回声学.

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