冠心病患者血浆高密度脂蛋白水平及其影响因素分析

Analysis of plasma high-density lipoprotein level and its influence factors in patients with coronary heart disease

目的:探讨冠心病发病与血清高密度脂蛋白胆固醇及其亚组分的相关性及影响因素。方法:随机选择行冠状动脉造影患者291例,使用PEG20000沉淀法测定HDL及其亚组分HDL2和HDL3,分析HDL及其亚组分分布特点。1)排除调脂药物影响后分为非冠心病组、冠心病无糖尿病组、冠心病合并糖尿病组;2)排除糖尿病影响后分为非冠心病组、冠心病未调脂组、冠心病调脂治疗组,对照分析糖尿病及调脂治疗对冠心病患者HDL及组成的影响。结果:冠脉造影正常者HDL显著高于冠心病患者(P<0.05);冠心病合并糖尿病患者HDL3及HDL3/HDL-C均显著降低(P<0.01);冠心病长期服用调脂药物者HDL和HDL2明显高于冠心病未服用调脂药物者(P<0.05,P<0.01)。结论:HDL与冠心病呈负相关,是冠心病的预测因子;冠心病合并糖尿病患者HDL3及HDL3/HDL明显低于无糖尿病者,调脂药物可以升高HDL和HLD2。

Objective： To analyze the distribution characteristics of high-density lipoprotein （HDL） and its particle subspecies in patients with coronary heart disease （CHD） and their influential factor. Methods： HDL subfractions were isolated from randomly selected 291 patients undergoing coronary, angiography with the PEG-20000 precipitation method. Results： The plasma HDL levels were significantly lower in CHD patients and diabetic patients complicated by CHD than in normal subjects and CHD patients not complicated by type 2 diabetes, respectively. HDL cholesterol and HDL2 were statistically increased in CHD patients treated with lipid-modifying drugs, while HDL3 was not significantly changed. Conclusion： Plasma HDL3 and HDI, levels are negatively related with CHD. Diabetic factor can change the levels of HDL-C and its subspecies.