摘要
本研究目的是分析老年男性尸检116例所见冠状动脉粥样硬化(AS)与生前血脂水平的关系。AS斑块按通用方法分级,以冠脉4支病变之和为总记分(CS)。将死亡2年以前的血脂平均值作为生前血脂基本水平。按CS高低分成3组。总胆固醇与低密度脂蛋白胆固醇(LDL-C)和CS成正相关,三组间差异非常显著。CS和高密度脂蛋白胆固醇(HDL-C)成负相关,但与甘油三酯无明显相关。多因素logistic回归分析显示高血压与糖尿病是病变加重的因素,高LDL-C引起冠脉AS的相对危险性最高。以CS与各项血脂作逐步判别分析,指出最有判断价值的指标是LDL-C与LDL-C/HDL-C比值。结果表明老年期与中年期一样,LDL-C升高是冠心病的主要脂类危险因素。
Coronaryatherosclerosis(AS)of116oldmen(aged82±8years)wasstudiedatau-topsy.Themaincausesofdeathofthesecaseswerecancer(33cases),respiratorydiseases(32cases)andcardiovasculardiseases(31cases).ThedegreofASlesionsofeachcoronarybranchwasgradedas0,Ⅰ,Ⅱ,Ⅲ,orⅣwithconventionalmethod.Thesumsofthegradesoffourmainbranch-esforeachcasewererecordedascoronaryscore(CS).Dataofmultipleannualserumlipidanalysiswereavailableintheperiodsofseveralyearsantemortem.Theaverageserumlipidsofeachcasetwoyearsbeforedeathwereusedasthebasiclipidlevelsinthestatistics.AcordingtotheseverityofAS(CS),thecasesweredividedinto3groups:severe,moderate,andmild(orinsignificant)withthecorrespondingCSof≥8,3-7and0-2.Totalcholesterolandlowdensitylipoproteincholesterol(LDL-C)werepositivelycorelatedwithCS,whilehighdensitylipoproteincholesterol(HDL-C)werenegativelycorelatedwithCS.Therewerenosignificantdiferenceintriglycerides,bodymassindex,andageamongthe3groups.Theresultsoflogisticregressionanalysisshowedincreasedcoro-naryASriskwithhypertensionanddiabetesmelitus.However,elevatedLDL-Chadthehighestrel-ativerisk(withOddsratioof5.00),multiplediscriminativeanalysisandstepwiseregressionanalysisbetweenseverityofcoronaryASandvariouslipidparametersshowedthatLDL-CandLDL-C/HDL-Cratiohadthebestdiscriminativevalue.Theabovestatisticalresultsindicatethattheserumlipidsinpredictingcoronaryriskarestilsignificantintheelderlymenaswelasintheyoungersubjects.
出处
《中华心血管病杂志》
CAS
CSCD
北大核心
1996年第4期278-281,共4页
Chinese Journal of Cardiology
基金
"八五"国家计划课题经费资助
关键词
冠状动脉硬化
血脂
尸体解剖
atherosclerosiscoronaryarterydiseaseserumlipi