冠心病患者血清γ-谷氨酰转移酶水平变化及其与血脂的关系

Change in serum gamma-glutamyltransferase in patients with coronary heart disease and its relationship with blood lipids

目的探讨冠心病患者血清γ-谷氨酰转移酶(GGT)的变化及与血脂的关系,分析冠心病GGT升高的临床意义。方法应用Olympus AU2700全自动生化分析仪测定726例冠心病患者的血清GGT、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)。按GGT测定值分为4级,逐级分析GGT与血脂的关系。结果726例冠心病患者中,GGT升高者143例,异常率19.67%。男性患者GGT异常率为19.57%,女性患者异常率为19.87%,男女患者间GGT异常率的差异无统计学意义(χ2=0.01,P>0.05)。男性冠心病患者血清TC、TG、LDL-C水平随着GGT活性升高而增高且血清GGT的不同级组间与TC、TG、LDL-C含量差异均有统计学意义(F=3.76,P<0.05;F=5.32,P<0.01;F=3.02,P<0.05);而女性冠心病患者GGT不同分级组间血脂水平的差异均无统计学意义(P均>0.05)。结论冠心病患者血清GGT水平升高,且男性患者GGT与TC、TG、LDL-C水平相关,而提示血清GGT升高有可能是冠心病的一种危险因素。

Objective To investigate the change in serum gamma-glutamyltransferase （GGT） in patients with coronary heart disease （CHD） and its relationship with blood lipids, and analyze the significance of GGT increase in CHD. Methods Serum GGT, total cholesterol （TC）, triglyceride （TG）, high density lipoprotein cholesterol （HDL-C）, and low density lipoprotein cholesterol （LDL-C） were determined in 726 patients with CHD using Olympus AU2700 automatic biochemistry analyzer. The results of GGT were classified into four grades： grade h GGT≤20U/L; grade lh GGT=21-30U/L; grade llh GGT=31-40U/L; grade IV： GGT〉40U/L. The relationship of GGT grades with blood lipids was analyzed. Results Of the 726 patients, 143 had increased GGT （19.67%）. The rate of abnormal GGT was 19.57% （82/419） in male patients and 19.87% （61/307） in female patients （χ^2=0.01, P〉0.05）. Most patients with CHD had mildly increased GGT, and only 1/4 patients had a GGT level higher than two times the normal GGT level. In male patients with CHD, serum TC, TG, LDL-C levels increased with GGT, and the TC, TG, LDL-C levels differed significantly between the GGT grades （F=3.76, P〈0.05; F=5.32, P〈0.01; F=3.02, P〈0.05）. In contrast, the blood lipid levels differed insignificantly between the GGT grades in female patients with CHD （P〉0.05）. Conclusions Serum GGT increase is common in patients with CHD, and the GGT level is related to the TC, TG, LDL-C levels in male patients. Serum GGT increase may be a risk factor for CHD.