绝经后女性冠状动脉病变与血脂代谢的关系

Correlation between lipids metabolism and coronary artery disease in postmenopause female patients

目的 :研究绝经后女性冠心病 ( CHD)患者血脂特点 ,探讨血脂代谢与冠状动脉病变的关系。方法 :以酶法测定和观察 94例经冠状动脉造影证实有一支以上主要冠状动脉狭窄≥ 5 0 %的绝经后女性 CHD患者的总胆固醇 ( TG)、甘油三酯 ( TC)、高密度脂蛋白胆固醇 ( HDL- C)、低密度蛋白胆固醇 ( L DL- C)、载脂蛋白 A1 、B( apo A1 、apo B) ,并以同期同年龄范围的健康体检女性 10 0例为对照组。结果 :1CHD组的 TG和 L DL- C明显高于对照组 ,HDL- C和 apo A1 明显低于对照组 ,而 TC仅轻度高于对照组 ;2多元逐步回归分析的有价值的判别指标为 apo A1 和 L DL- C;3 CHD组高 TG者 5 4例 ( 5 3 .2 % ) ,高 TG者冠状动脉双支及三支病变 2 9例 ( 5 8% ) ,而TG正常者双支及三支病变 13例 ( 2 9.5 % )。结论 :女性绝经后 CHD患者高 TG,高 L DL - C,低 HDL - C和低 apo A1是 CHD的重要危险因素 ,apo A1 和 L DL - C在致 CHD方面意义更大 ,其中高

Objective: To investigate the lipids profile of patients with coronary heart disease (CHD) in postmenopause females, and explore the relation between serum lipids and coronary artery disease. Method: Ninety four postmenopause female CHD documented by angiography were selected as CHD group and 100 normal female subjects as control. Result: The serum levels of triglyceride (TG) and low density lipoprotein cholesterol (LDL C) in CHD group were higher than those in control group, but the levels of apolipoprotein A 1 (apo A 1) and high density lipoprotein cholesterol (HDL C) in CHD group were much lower than those in control group, while the level of TC in CHD group was slightly higher than that in control group.Multivarietic regression analysis showed that the valuable indicators were apoA 1 and LDL C. Among CHD group, 53.2 % patients were complicated with high TG; and among patients with high TG, there were 29 cases (58%) suffered from stenotic losion in 2 or 3 branches of coronary artery. While in patients with normal level of TG, only 13 cases ( 29.5 %) suffered from similar condition. Conclusion: In postmenopause females, hypertriglyceridemia, high level of LDL C, low level of HDL C and apoA 1 are risk factors of CHD. LDL C and apo A 1 may promote CHD more directly. The lesion of coronary artery is more severe in patients with CHD who has hypertriglyceridemia.