冠心病不同程度冠脉狭窄时红细胞流变特性、血脂和纤维蛋白原变化及相关性分析

Changes of erythrocyte rheological properties, serum lipid and fibrinogen in coronary heart disease with various degrees of coronary stenoses

目的：探讨冠心病（ＣＨＤ）不同程度冠脉狭窄时红细胞流变特性、血脂及纤维蛋白原（Ｆｇ）的变化及意义。方法：２９例ＣＨＤ病人按冠脉主要分支最大狭窄程度不同分为明显狭窄组（ＯＳ）和轻度狭窄组（ＭＳ），测定各组红细胞变形指（ＤＩ）、红细胞聚集率（ＥＡＲ）及血脂各组份ＦＧ。结果：ＣＨＤ二亚组红细胞流变特性、甘油三酯（ＴＧ）、高密度脂蛋白胆固醇（ＨＤＬ－Ｃ）、载脂蛋白Ａ１（ａｐｏＡ１）、载脂蛋白Ｂ（ａｐｏＢ）、ＴＧ／ＨＤＬ－Ｃ、ＣＨ／ＨＤＬ－ｃ及ＦＧ在ＣＨＤ冠脉明显狭窄组的改变较轻变狭窄组更明显（Ｐ＜０．０５）。结论：上述参数可能对于区分ＣＨＤ有或无意义冠脉狭窄具有预示价值。

Objective: To investigate changes of erythrocyte rheological properties, serum lipid and fibrinogen (FG) in coronary heart disease (CHD) with various degrees of coronary stenoses and their significance. Methods: On the basis of the degrees of coronary maximal stenoses, 29 patients with CHD were divided into two groups: 1) obvious stenoses (OS, narrowing in luminal diameter > 50%, n=15); 2) mild stenoses (MS, narrowing in luminal diameter < 50%, n=14). The erythrocytic deformability index (EDI), erythrocytic aggregation rate (EAR) and FG in components of serum lipid were determined. Results: Significant changes of the EDI, triglyceride (TG), apolipoprotein A1, highdensity lipoprotein cholesterol (HDLc), CH/HDLc, TG/HDLc and FG were found in OS as compared with MS (P<0.05). Conclusion: EDI, TG, HDLc, CH/HDLc, TG/HDLc and FG may be of predictable value in differing CHD patients with significant coronary stenoses from those without. 