A Research On The Relationship Of Lipoprotein(a) And D-dimer And Red Cell Distribution Width Level With The Severity Of Coronary Artery Lesions

Objective:By measuring the level of the plasma lipoprotein(a),D-dimer and the Red cell distribution width,to explore the relationship of lipoprotein(a)and D-dimer and red cell distribution width with the degree of Coronary Artery Disease.Methods:Select the First Affiliated Hospital of Wan Nan medical college from October 2013 to December 2014 211 cases diagnosed as "chest pain " patients.According to the results of coronary angiography(CAG),were divided into 140 cases of the coronary heart disease(CHD)group and 71 cases of control group.According to the number of diseased vessels,the CHD group was divided into single-vessel disease(71 cases),double-vessel disease(36 cases)and multivessel disease(33 cases).Then according to Gensini scoring criteria to evaluate the coronary artery stenosis degree,according to the scores level of three quantile divided into group 1(Gensini score<20)82 cases,moderate disease group 2(20≦Gensini score< 45)37 cases and severe disease group 3(Gensini score ≧ 45)21 cases.All selected patients were collected fasting samples from the median cubital vein in the next early morning,in order to measure the levels of Lipoprotein(a)and D-dimer and Red cell distribution width by automatic biochemical analyzer.Analysis of CHD,coronary disease count,Gensini score and Lp(a),D-dimer,RDW correlation by SPSS17.0 software.Results:1 Comparison of coronary heart disease group and the control group,coronary heart disease on age,the proportion of men,LP(a),LDL-C,the proportion of diabetes was significantly higher,the difference was statistically significant(P<0.05).Comparison of coronary heart disease group and the control group,coronary heart disease on smoke,HDL-C,TC,TG,RDW,was significantly higher,the difference was not statistically significant(P>0.05).2 According to the number of diseased vessels,the CHD group was divided into single-vessel disease(group ?)71 cases,double-vessel disease(group ?)36 cases and multivessel disease(group ?)33 cases.Three groups of Lp(a)level was statistically significant(P <0.05).Further pairwise comparison,group ? was significantly higher than the group ?,group ?,group ? was significantly higher than the group ?.The difference was statistically significant(P<0.05).Three groups of LDL-C、HDL-C、TC、TG、RDW、D-D、Apo A、Apo B、Apo B/Apo A level was not statistically significant(P >0.05).3 According to Gensini scoring criteria to evaluate the coronary artery stenosis degree,according to the scores level of three quantile divided into group ?(Gensini score<20)82 cases,moderate disease group ?(20<Gensini score< 45)37 cases and severe disease group ?(Gensini score≧45)21 cases.Three groups of Lp(a)level was statistically significant(P <0.05).Further pairwise comparison,group ? was significantly higher than the group ?,group ?,group ? was significantly higher than the group ?.The difference was statistically significant(P<0.05).Three groups of LDL-C、HDL-C、TC、TG、RDW、D-D、Apo A、Apo B、Apo B/Apo A level was not statistically significant(P>0.05).4 Correlation analysis suggested that LP(a)level and Gensini score,the number of vascular lesions was highly positive correlated(r =0.869,P <0.05;rs =0.816,P <0.05),HDL-C level and Gensini score was negatively correlated(rs =-0.244,P <0.05).While LDL-C、HDL-C、TC、TG、RDW、Apo A、Apo B、Apo B/Apo A and D-D all were not related with Gensini score,the number of vascular lesions(P>0.05).5 Logistic regression analysis suggested that age,Lp(a),LDL-C,sex were risk factors for coronary disease,βvalues were:1.06,0.01,0.59,1.18(P<0.05).Conclusion:1 With the increase of Lipoprotein(a)levels,the number of vascular lesions and Gensini score also increased,the degree of coronary artery disease is more serious.2 Lipoprotein(a)level and Gensini score,the number of vascular lesions was highly positively correlated.The severity of coronary artery disease can be evaluated from Gensini score and the number of vascular lesions.Lipoprotein(a)level in the clinic could help to evaluate the degree of coronary artery disease and to predict coronary heart disease.3 coronary artery disease patients with elevated Lipoprotein(a)level have no effect on coronary artery lesions.