【摘要】 目的通过检测血浆D-二聚体的变化来判断不同类型冠心病患者体内新鲜血栓形成的可能性,并研究D-二聚体的变化及其与血脂异常的相关性。方法对120例不同类型的冠心病患者与30例正常人分别采用ELISA法测定血浆DD水平和脂蛋白(a)、酶法测定甘油三酯(TG)、胆固醇(TC)和高密度脂蛋白(HDL)、用免疫散射比浊法测定载脂蛋白AI(Apo AI)和载脂蛋白B(Apo B),将冠心病患者与正常人的Lp(a)、TG、TC、HDL、Apo AI、Apo B进行比较。结果①与正常人相比,稳定性心绞痛、陈旧性心肌梗死组患者DD水平未改变(P>0.05),急性心肌梗死组患者DD水平显著升高(P<0.05),不稳定性心绞痛组患者DD水平有所升高(P<0.05),急性心肌梗死组与不稳定性心绞痛组比较差异显著(P<0.05);与稳定性心绞痛组、陈旧性心肌梗死组相比较,不稳定性心绞痛组、急性心肌梗死组患者DD水平显著升高(P<0.05)。②DD与TG、Apo B和Lp(a)呈明显正相关(r=0.393、0.650和0.579,P<0.05);DD与TC成正相关关系(r=0.235,P<0.05);与Apo AI和HDL呈负相关(r=-0.479和-0.178,P<0.05)。结论在急性心肌梗死组和不稳定性心绞痛组患者中,DD指标的增高,可能容易伴发高凝状态和新鲜血栓的形成;急性心肌梗死患者中,DD指标的增高更容易造成血栓的形成,血脂异常对冠心病患者的DD水平有影响,其中Apo B和Lp(a)为独立影响DD的血脂指标。更多还原

【Abstract】 Objective To determine the possibility of fresh thrombosis in different types of coronary heart disease patients by detecting the changes of plasma D- two, and to study the changes of D- two polymer and its relationship with dyslipidemia. Methods 120 cases of patients with different types of coronary heart disease and 30 normal controls were measured by ELISA DD plasma levels and lipoprotein(a), enzymatic determination of triglycerides(TG), cholesterol(TC) and high density lipoprotein(HDL), the determination of apolipoprotein AI by immune nephelometry(Apo AI) and apolipoprotein B(Apo B), the coronary heart disease patients and normal persons a, TG, TC, HDL, Apo AI and Apo B were compared. Results Compared with normal, stable angina, myocardial infarction patients DD level group did not change(P>0.05), acute myocardial infarction group DD significantly increased(P<0.05), unstable angina group, the level of DD increased(P<0.05), acute myocardial infarction group and not stable angina group was significantly different(P<0.05); compared with stable angina group, myocardial infarction group, unstable angina pectoris and acute myocardial infarction group were markedly elevated levels of DD(P<0.05). ② The DD and TG, Apo B and Lp(a) showed a positive correlation(r=0.393, 0.650 and 0.579,P<0.05); DD and TC are positively correlated(r=0.235, P<0.05); and negatively correlated with Apo AI and HDL(r=-0.479 and-0.178, P<0.05).Conclusion Acute myocardial infarction group and unstable angina group, DDindex increased, may be associated with hypercoagulability and fresh thrombosis; acute myocardial infarction patients, increased DD index is more likely to cause thrombosis, DD water for dyslipidemia in patients with coronary heart disease is influence, including Apo B and Lp(a) for the independent effect of fat index DD.更多还原