非高密度脂蛋白胆固醇与冠状动脉病变程度及危险因素的关系

Association of non-high density lipoprotein cholesterol levels with coronary artery disease, extent of angio- graphic coronary artery lesions and risk factors

目的观察非高密度脂蛋白胆固醇（non—HDL—C）与冠状动脉病变程度及冠心病（CHD）危险因素的关系。方法检测411例临床怀疑CHD行冠状动脉造影患者血清总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL-c）、低密度脂蛋白胆固醇（LDL—C）、脂蛋白（a）[Lp（a）]、载脂蛋白A（ApoA）、载脂蛋白B（ApoB）浓度。计算non—HDL—C及LDL—C／HDL比值。采用Logistic回归分析及偏相关分析non—HDL—C与CHD的关系。结果CHD组与非CHD组相比，血浆non—HDL—C[（3．40±1．01）mmol／L比（308±0．65）mmoL／L，P〈0．05]、LDL—C[（2．63±0．84）mmol／L比（2．40±0．54）mmol／L，P〈0．05]、TC[（4．48±1．07）mmol／L比（4．23±0．69）mmol／L，P〈0．05]及LDL—C／HDL比值[（2．52±0．96）比（2．21±0．74），P〈0．05]均显著高于非CHD组。多因素Logistic回归分析non—HDL—C是唯一与CHD存在相关性的血清学指标。偏相关分析提示non．HDL．C与冠脉病变支数（r=0．250，P〈0．01）及冠脉病变积分（r=0．116，P〈0．05）正相关。结论non—HDL—C是CHD独立的危险因子，且能反映冠脉病变的严重程度。

Objective To observe the correlation between non-high density lipoprotein cholesterol levels and coronary artelT disease（CAD） ,extent of angiographic coronary artery lesions and risk factors of CAD. Methods Serum total cholesterol （ TC ） , triglyceride （ TG ） , high density lipoprotein cholesterol （ HDL-C ） , low density lipoprotein （LDL-C）, Lp（a） , apoA-I and apo B levels were measured in 282 patients with angiographie CAD meanwhile in 129 normal controls without angiographic coronary artery lesions. Non-HDL-C and LDL-C/HDL ratio was calculated. Lo- gistic regression and partial correlation were used to find the correlation of serum non-HDL-C with CAD. Results Non-HDL-C I （3.40 ± 1. 01 ） mmol/L vs （ 3.08 ± 0.65 ） mmol/L, P 〈 0.05 ], LDL-C [ （ 2.63 ± 0.84 ） mmol/L, vs （ 2.40 ± 0.54 ） retool/L, P 〈 0.05 ], TC [ （ 4.48 ± 1.07 ） mmol/L vs （ 4.23 ± 0.69 ） mmol/L, P 〈 0, 05 ], and LDL-C/HDL ratiu[ （2.52 ±0.96） vs （2.21±0.74） ,P 〈0.05]were significantly higher in the CAD group than in the con- trol group. The four indexes also showed an increasing trend in the sequence of single, double and triple vessel le- sions. Multivariate I^gistie regression analysis found that among lipid factors, only non-HDL-C was independently as- sociated with CAD. The results of partial correlation analysis demonstrated that non-HDL-C was positively correlated to the number of lesions （ r = 0. 250, P 〈 0.01 ） and gensini acore of CAD （ r = 0. 116, P 〈 0.05 ）. Conclusion Non- HDL-C level is an independent risk factor for CAD and significantly correlated with the severity of CAD.