冠心病患者血脂多指标联合检测结果分析

Analysis of Blood Lipid Levels of the Patients with Coronary Heart Disease

目的探讨脂类代谢与冠心病(CHD)之间的密切关系,为冠心病的预测及临床诊断提供参考依据。方法分别采用免疫比浊法、酶法、选择性抑制法对180例冠心病患者及40例健康成人的血清低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、载脂蛋白A1(ApoA1)、载脂蛋白B100(ApoB100)、总胆固醇(TC)和甘油三酯(TG)水平进行分析测定。结果与正常对照组相比,冠心病患者血清TC、TG、ApoB100和LDL-C水平及LDL-C/HDL-C、LDL-C/ApoA1和TC/HDL-C比值显著增高,而血清HDL-C和ApoA1水平及ApoA1/ApoB100比值显著降低(P均<0.01);采用LDL-C、HDL-C、ApoA1、ApoB100、TC和TG等多指标的联合分析时,冠心病患者的脂类代谢异常率高达88.3%,远远高于单纯检测TC和TG时的26.7%(P<0.01);TC和TG均正常的非高脂血症患者中有84.1%的患者普遍存在一项和/或多项的脂类代谢异常,显著高于正常人(P<0.01);TC为临界水平时脂类代谢异常的阳性率要明显高于TC为理想水平时(P<0.05)。结论冠心病患者普遍存在脂类代谢异常,脂类代谢异常与冠心病的发生发展密切相关,多指标的联合分析可以更全面准确地对患者的冠心病危险性进行评估。

Objective To evaluate the close correlation between blood lipids and coronary heart disease （CHD） and to provide predictive and diagnostic parameters for CHD. Methods Blood lipid levels of 180 patients with CHD and 40 healthy control subjects had been determined by immunonephelometry, enzyme assay and selective inhibition assay. Blood lipid parameters included low-density lipoprotein cholesterol （LDL-C）, high-density lipoprotein cholesterol （HDL-C）, apolipoprotein A1 （ApoA1）, apolipoprotein ApoB 100 （ApoB 100）, total cholesterol （TC） and triglyceride （TG）. Results Compared with control subjects, blood levels of TC, TG, ApoB100 and LDL-C in CHD group increased significantly. So did the ratios of LDL-C/HDL-C, LDL-C/ApoA1 and TC/HDL-C. Contrary, blood levels of HDL-C and ApoA1 and ApoA1/ApoB100 ratio significantly decreased （P〈0.01）. There were abnormal Blood lipid parameters in 88.3% CHD patients showed by multiparameter combined analysis, which was far higher than the analysis of TC and TG alone （26.7%, P〈0.01）. There were one or more abnormal blood lipid parameters in 84.1% non-hypedipidemia patients with normal levels of TC and TG, which was higher than that in control subjects （P〈 0.01 ）. Frequency of abnormality in subjects with critical level of TC was higher than in subjects with expected level of TC （P〈0.05）. Conclusion Abnormality of blood lipids was universal in CHD. There was close correlation between abnormal blood lipids and generation and development of CHD. Multiparameter combined analysis could evaluate the risk of CHD more accurately.