急性冠脉综合征患者血脂不同成分水平的变化

Different levels of lipid composition in patients with acute coronary syndrome

目的了解急性冠脉综合征(ACS)患者血清中血脂不同成分的改变,探讨其在冠心病的进展及恶化过程中的作用及临床意义。方法对367例患者的冠状动脉造影结果及临床一般资料,血脂检查结果进行分组对比分析。结果ACS组268例,对照组99例,ACS组脂蛋白a[Lp(a)]水平为(225.3±171.2)mg/L,显著高于对照组(182.8±180.1)mg/L(P<0.05),高密度脂蛋白胆固醇(HDL-C)、载脂蛋白A(ApoA1)水平分别为(1.0±0.2)mmol/L和(1142.4±189.7)mg/L,显著低于对照组(1.1±0.3)mmol/L和(1273.9±187.5)mg/L(P<0.05),而总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白B(ApoB)水平与对照组差异无统计学意义(P>0.05)。结论Lp(a),HDL-C和ApoA1的水平在急性冠脉综合征患者和对照组患者中差异有统计学意义,提示我们在重视降低患者的TC、TG和LDL-C水平的同时,也应该关注HDL-C、ApoA1和Lp(a)水平对冠心病的影响。

Objective To investigate the changes of lipid composition levels in patients with acute coronary syndrome and to discuss its clinic effect in progress and deteriorate of coronary artery disease. Methods 367 patients were divided into acute coronary syndrome group and control group by coronary angiography. The results of coronary angiography, clinical formations and the blood lipid levels were analyzed by contrast method. Results The level of Lp（a） in ACS group was significantly higher than in control group [ （225.3±171.2）mg/L vs （182.8± 180.1）rag/L, P〈0.05]. The level of HDL-C and ApoA1 in ACS group were （1.0±0.2）mmol/L and （1142.4± 189.7）mg/L respectively, significantly lower than in control group [ （1.1±0.3）mmol/L and （1273.9±187.5）mg/L respectively ] （P〈0.05）. There was no difference in levels of TC ,TG, LDL-C and ApoB between the two groups（P〉 0.05）. Conclusion There was significant difference of the levels of Lp （a）,HDL-C and ApoA1 in patients with ACS. This indicated that we should pay more attention to the influence of HDL-C,ApoA1 and Lp （a） to coronary artery disease except for TC, TG and LDL-C.