冠心病患者血浆氧化修饰低密度脂蛋白水平的变化

Changes of the levels of plasma oxidatively modified low density lipoprotein in patients with coronary heart disease

对８６例冠心病（ＣＨＤ）患者及６０例正常对照组血浆氧化修饰低密度脂蛋白（ＯＸ－ＬＤＬ）及血脂、脂蛋白和载脂蛋白（ａｐｏ）水平进行了测定。结果显示ＣＨＤ患者血浆ＯＸ－ＬＤＬ、血清甘油三酯（ＴＧ）、低密度脂蛋白（ＬＤＬ）及ａｐｏＢ１００均显著高于正常对照组，而血清高密度脂蛋白（ＨＤＬ）、ａｐｏＡＩ及ａｐｏＡＩ／ａｐｏＢ１００均显著低于正常对照组；相关分析表明，血浆ＯＸ－ＬＤＬ水平与ＴＧ、ＬＤＬ、ａｐｏＢ１００水平均呈显著正相关，而与ＨＤＬ、ａｐｏＡＩ及ａｐｏＡＩ／ａｐｏＢ１００水平均呈显著负相关；多元逐步回归分析表明ＯＸ－ＬＤＬ对ＣＨＤ的预测价值优于目前临床常用的血脂、脂蛋白及ａｐｏ。认为，ＯＸ－ＬＤＬ与ＣＨＤ的发生发展密切相关，ＣＨＤ患者体内ＬＤＬ氧化修饰增加，在治疗过程中应加强抗氧化治疗以抑制ＬＤＬ在体内的氧化修饰。

The levels of plasma oxidatively modified low density lipoprotein.(OX-LDL),serum lipid, lipoproteins and apolipoproteins were investigated in 86 patients with coronary heart disease(CHD) and 60 normal controls. It was found that the values of OX-LDL,TG, LDL-C, apoB100 in CHD were markedly higher(P<0.01～0.001) than those of normals, the values of HDL-C,apoAI ,apoAI/apoB100 were significantly lower(P<0. 001);no significant difference was found in the values of OX-LDL,TC,TG, HDL-C, LDL-C,apoAI, apoB100 among the patients with angina pectoris, acute myocardial infarction and old myocardial infarction. The analysis of linear correlation showed that the level of OX-LDL negatively correlated with those of HDL-C,apoAI, apoAI/apo B100(P<0. 001), but positively correlated with those of TG, LDL-C, apoB100. Multiple steped regressive analysis showed that the dignostic value of OX-LDL to CHD was better than other serum lipids, lipoproteins and apolipoproteins. It suggests that OX-LDL plays an importent role in the progress of coronary atherosclerosis and the administration of antioxidants in the treatment of CHD should be concerned.