在患有非阻塞性冠状动脉疾病的患者中,冠状动脉微血管功能障碍与脂蛋白 (a) 水平的关联
Eleni Adamopoulou1, Kyriakos Dimitriadis2, Athanasios Sakalidis2
1First Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Hippokration General Hospital, 115 27, Athens, Greece; Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, 115 27, Athens, Greece.
The American journal of cardiology
|February 28, 2026
概括
高脂蛋白 (a) [Lp(a) ]水平可能与心脏病患者的冠状动脉微血管功能障碍 (CMD) 有关. 需要进一步的研究来证实这种关联及其对心血管疾病的临床影响.
科学领域:
- 心脏病学 心脏病学
- 血管生物学 血管生物学
- 生物标志物 生物标志物
背景情况:
- 冠状动脉微血管功能障碍 (CMD) 是冠状动脉疾病的一个新兴因素.
- 传统的风险因素与CMD有关,但脂蛋白 (a) [Lp(a) ]的作用尚不清楚.
- 有限的数据存在Lp(a) 和CMD之间的关联在患有心痛和非阻塞性冠状动脉的患者中.
研究的目的:
- 调查脂蛋白 (a) [Lp(a) ]水平与冠状动脉微血管功能障碍 (CMD) 之间的关联.
- 评估Lp(a) 水平在患有非阻塞性冠状动脉心痛的患者中.
- 为了确定升高的Lp (a) 是否是该患者队列中CMD的风险因素.
主要方法:
- 横截面研究涉及127名患有心痛和非阻塞性冠状动脉的患者.
- 使用玻尿酸热稀释评估冠状动脉生理学,以测量冠状动脉流量储备 (CFR) 和微血管阻力指数 (IMR).
- 根据Lp (a) 水平 (<30 mg/dl,[30-50] mg/dl,≥50 mg/dl) 和CMD存在 (CFR ≤2.5和/或IMR ≥25) 进行分类的患者.
主要成果:
- 在患者组之间没有观察到显著的基线差异.
- 多变量分析显示,与Lp (a) ≥50 mg/dl (p=0.087) 患者相比,Lp (a) <30 mg/dl (p=0.087) 患者的CMD风险增加趋势 (OR4.25).
- 与对照组相比,高Lp(a) 水平 (≥50 mg/dl) 的患者往往具有较低的CFR (中位数差异为1.05单位,p=0.086).
结论:
- 升高的脂蛋白 (a) [Lp(a) ]水平显示出与冠状动脉微血管功能障碍 (CMD) 和较低冠状动脉流量储备 (CFR) 的更高患病率相关的趋势.
- 这些发现表明Lp (a) 在CMD病变发生过程中可能发挥作用.
- 需要进一步的研究,以阐明Lp(a) 和CMD之间的确切关系.
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