【摘要】 目的探讨脂蛋白(a)[Lp(a)]与性别在中国汉族人群首发急性心肌梗死(AMI)中的交互作用。方法对2010—2013年就诊于苏州大学附属第一医院的1 522例首发AMI患者和1 691例冠状动脉造影正常或冠状动脉直径狭窄<50%的患者采用logistic回归模型进行回顾性分析。经多因素校正后,用相加模型和相乘模型来评估Lp(a)和性别在AMI中的交互作用。结果危险因素经校正后,男性和女性随着Lp(a)水平的升高,首发AMI的OR值均增加。男性较女性首发AMI的OR值增加明显,Lp(a)在Q5时,RERI(95%CI)为2.63(0.76～4.50),存在相加交互作用,无相乘交互作用。结论在中国汉族人群中,性别与Lp(a)在首发AMI中存在相加交互作用,男性Lp(a)水平上升显著增加了首发AMI的风险。更多还原

【Abstract】 Objective To explore the interaction between gender and lipoprotein(a)(Lp(a)) on the initial acute myocardial infarction(AMI) in Chinese Han population. Methods The 1 522 patients with first AMI in Department of Cardiology of the First Affiliated Hospital of Soochow University from 2010 to 2013 were enrolled into this study. The 1 691 patients with normal coronary angiography or coronary stenosis <50% at the same time were enrolled as control group. Logistic regression model was used to analyze the interaction of Lp(a) and gender in AMI after adjustment for risk factors. Results After adjusting for risk factors, the odds ratio(OR) of first AMI increased with the increase of Lp( a) level in both men and women. The OR of first AMI in male was significantly higher than that in female. Lp(a) at Q5, RERI(95%CI) = 2. 63( 0. 76-4. 50), and there was additive interaction between gender and Lp( a), no multiplicative interaction. Conclusions In Chinese Han population, gender and Lp(a) in the first AMI exist additive interaction. Lp(a) levels in male significantly increased the risk of first AMI.更多还原