非高密度脂蛋白胆固醇对原发性高血压患者左室舒张功能不全的影响

The influence of non-high-density lipoprotein cholesterol on left ventricular diastolic dysfunction in patients with essential hypertension

目的评价原发性高血压患者的血脂谱，尤其是非高密度脂蛋白胆固醇（non—HDL—C）与左室舒张功能不全（LVDD）的相关性。方法入选心内科门诊的原发性高血压患者，使用组织多普勒成像（TDI）测量的E／E’比值和E’／A’比值反映左室舒张功能障碍程度分级，分析血脂指标与左心室舒张功能的相关性，使用ROC曲线分析血脂指标评价左室舒张功能障碍的敏感性和特异性。结果高密度脂蛋白胆固醇（HDL—C）与左室舒张功能呈负相关，non—HDL—C与左室舒张功能呈正相关。在评价左心室舒张功能不全方面，non—HDL—C与HDL相比，具有更高的敏感性和特异性。结论non—HDL—C与原发性高血压患者左室舒张功能障碍明显相关，且较甘油三酯（TG）和低密度脂蛋白胆固醇（LDL—C）相关性更好，对左室舒张功能障碍的早期诊断具有很好的临床意义。

Objective Evaluate lipid profile in the patients of essential hypertension, especially the correlation between non-HDL-C（non-high density lipoprotein cholesterol）, and LVDD （left ventricular diastolic dys- function）. Methods Patients with essential hypertension in department of cardiology out-patient were enrolled. In order to reflect the left ventricular diastolic dysfunction degree classification, E/E＇ ratio and E＇/A＇ ratio were evaluated by TDI （tissue doppler imaging）. The correlation between serum lipids and left ventricular diastolic func- tion was analyzed. The sensitivity and specificity of left ventricular diastolic dysfunction with the lipid parameters were evaluated by ROC curve analysis. Results High density lipoprotein cholesterol was negatively correlated with left ventricular diastolic function, non-HDL-C was positive correlated with left ventricular diastolic function. Non- HDL-C has a higher sensitivity and specificity to HDL（high density lipoprotein cholesterol）. Conclusion There is obviously relevant between non-HDL-C and essential hypertension patients with left ventricular diastolic dysfunc- tion, which indicates that non-HDL-C may has earlier clinical diagnosis significance to patients with left ventricular diastolic dysfunction.