冠状动脉病变与血脂代谢异常的相关性

Study of the correlation between abnormal lipid metabolism and the severity of coronary artery lesions

目的 探讨冠状动脉病变与血脂代谢紊乱的关系。方法 将2 6 7例疑似冠心病的患者依据冠状动脉造影结果分为对照组(非冠心病组) 1 0 1例,冠心病组1 6 6例,其中单支病变组54例,双支病变组6 8例,三支病变组4 4例,同时测定并统计分析血脂各成分及其比值与冠状动脉病变之间的关系。结果 冠心病(CHD)组总胆固醇(TC)、低密度脂蛋白胆固醇(LDL- C)、甘油三脂(TG)水平明显高于对照组,高密度脂蛋白胆固醇(HDL C)水平明显低于对照组,差异有统计学意义。随着冠状动脉病变范围的增加,TC、LDL C、载脂蛋白B(ApoB)、TC HDL- C、LDL- C HDL- C升高,HDL- C降低,与对照组比较,差异有统计学意义。冠心病组血脂各组分和其比值与冠状动脉积分的相关分析表明,TC HDL- C、LDL -C HDL -C与冠状动脉病变的相关性最强。结论 血脂代谢紊乱的严重程度与冠状动脉病变的严重程度是一致的,通过异常的血脂代谢有可能初步预测冠状动脉病变,其中LDL- C HDL- C、TC- HDL C比值优于其他血脂指标。

Objective To investigate the correlation between abnormal lipid metabolism and coronary artery lesions. Methods Two hundred and sixty seven patients were devided into the control group ( n =101) and the coronary heart disease (CHD) group ( n =166), which included single vessel lesion ( n =54), double vessel lesions ( n =68) and triple vessel lesions ( n =44) according to coronary angiography. At the same time the lipid components were examined and the ralationship between serum lipid level and coronary artery lesions were analysed. Results Compared with the control, the total cholesterol (TC), low density lipoprotein cholesterol (LDL-C) and triglyceride (TG) level were significantly elevated while but high density lipoprotein cholesterol (HDL-C) was lowered in the CHD group. The severity of coronary lesions was increased with the elevation of TC, LDL-C, apolipoproteinB (ApoB), TC/HDL-C, LDL-C/HDL-C, and the reduction of HDL-C. There were significant differences in terms of lipid level beteewn the CHD group and the control. The analysis showed that TC/HDL-C and LDL-C/HDL-C were most directly correlated with the coronary artery lesions in the CHD group. Conclusion The results suggest that the severity of coronary artery lesions correlated with abnormal lipid metabolism, and LDL-C/HDL-C, TC/HDL-C are better indicators than other lipid components.