RESUMEN
Objective To investigate the correlation of serum lipoprotein(a)[Lp(a)]level and coronary artery lesion degree in elderly coronary heart disease (CAD) patients with type 2 diabetes mellitus.Methods 163 elderly patients with CAD in accordance with the control fasting glucose(FPG)levels on admission were divided into A,B,C three groups:FPG 7.1 mmol/L for group C (44 cases).The clinical data,count in patients with coronary artery lesions and lesion severity index(Gensini score),blood lipid and lipoprotein(a)[Lp(a)],etc were recorded.Results There was significant difference in serum Lp(a)among three groups(F =21.577,P <0.001),the Lp(a)of group C [(413.5 ±63.1)mmol/L]was higher than group B[(376.3 ±58.3)mmol/L],group B was higher than group C [(335.3 ±52.5 )mmol/L].The differences of serum Lp (a)between coronary lesion groups were statistically significant(F =69.447,P <0.001),three lesion group Lp(a)[(436.6 ±60.2)mmol/L]was higher than the double branch lesions[(362.5 ±55.7 )mmol/L],double branch lesion group was higher than the single lesion group [(315.4 ±49.9)mmol/L];Gensini score between different coronary lesions group had significant differences (F =179.969,P <0.001),three lesion group Gensini score[(61.9 ±15.4)points]was higher than double branch lesion group[(34.3 ±12.5 )points],double branch lesion group was higher than the single lesion group [(17.2 ± 9.1)points];Lp(a)≥372.3 mmol/L group Gensini score[(58.4 ±12.5)points]was significantly higher than the Lp(a)<372.3 mmol/L group[(19.2 ±10.3)points](t =21.836,P <0.01);Lp(a)≥372.3 mmol/L group three lesions proportion(57.3%)was significantly higher than 18.5% of Lp(a)<372.3 mmol/L group(χ2 =37.142, P <0.001);Pearson correlation analysis showed that the serum level of Lp(a)was positively related with Gensini score(r =0.439,P <0.001 );Multiple linear regression analysis showed that the Lp(a)was the independent risk factors affecting the Gensini score(β=4.210,P <0.001).Conclusion In elderly patients with CAD 2 diabetes significantly higher serum levels of Lp(a),the higher level is closely related to the severity of coronary lesions,and can be used as an independent predictor of coronary artery lesion severity.