血清脂蛋白与冠状动脉病变的关系

Relationship between serum lipids and severity of coronary heart disease

目的:探讨血清脂蛋白水平与冠脉病变程度之间的关系。方法:回顾性分析311例行选择性冠状动脉造影的患者,其中267例冠心病(CHD)患者分为稳定型心绞痛(SAP)和急性冠脉综合征(ACS)组,分别测定总胆固醇(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),载脂蛋白AI(Apo-AI),载脂蛋白B(Apo-B),脂蛋白a(Apoa),计算出LDL/HDL-C和TG/HDL。比较各组血清脂蛋白水平的差异及与冠状动脉病变程度的相关性,并与44例冠脉造影正常组比较。结果:CHD组HDL-C、Apo-AI较对照组显著降低;ACS组较SAP组HDL-C、Apo-AI显著降低(P<0.01)。血浆Apo-B水平越高,患者冠状动脉病变血管数越多。结论:HDL-C、Apo-AI与冠脉病变程度具有负相关关系;而Apo-B水平与冠状动脉硬化范围呈正相关。

Objective：To investigate the relationship between degree of coronary stenosis and levels of serum lipids. Methods：311 patients undergoing coronary arteriography（CAG）were chosen. 267 patients diagnosed as coronary heart disease（CAD） were divided into stable angina pectoris （SAP） and acute coronary syndrome （ACS） groups. Serum total cholesterol, triglycerides, high density lipoprotein cholesterol, low density lipoprotein cholesterol, apolipoprotein-AI, apofipoprotein-B, and lipoprotein（a） were determined before CAG. Correlations between blood lipid and severity of coronary heart disease were analyzed. 44 healthy subjects served as control group. Results： The levels of serum HDL-C and Apo-AI were lower in patients with coronary disease compared with those in control group （P〈0.05）. In comparison with patients with SAP, ACS patients had higher concentrations of serum HDLC and Apo- AI （P〈0.05）. The extent of CAD was related to ApoB level. Conclusion： Low levels of HDL-C and Apo-AI and high ApoB levels exert a worsening effect on major adverse cardiac events in patients.