久居亚高原地区的冠心病患者血脂异常分析

Study of Lipids Ratios on Coronary Heart Disease at Subhigh Altitude

目的：探讨久居亚高原地区的冠心病患者总胆固醇（ＴＣ）／高密度脂蛋白胆固醇（ＨＤＬ－Ｃ）和（ＴＣ－ＨＤＬ－Ｃ）／ＨＤＬ－Ｃ值异常及其它传统危险因素对冠心病发病的影响。 方法：分析１０５例冠状动脉造影（ＣＡＧ）确诊的冠心病患者（冠心病组）及６５例ＣＡＧ阴性者（非冠心病组）的ＴＣ／ＨＤＬ－Ｃ和（ＴＣ－ＨＤＬ－Ｃ）／ＨＤＬ－Ｃ值及血压、血糖、吸烟等与冠心病之间的关系。 结果：ＴＣ、甘油三酯（ＴＧ）、低密度脂蛋白胆固醇（ＬＤＬ－Ｃ）浓度升高率在２组中无显著性差异，但ＴＣ／ＨＤＬ－Ｃ、（ＴＣ－ＨＤＬ－Ｃ）／ＨＤＬ－Ｃ值异常率在冠心病组显著高于非冠心病组，有非常显著性差异（Ｐ＜０．００１），其比值升高与冠心病的危险性是非冠心病组的７倍。 结论：ＴＣ／ＨＤＬ－Ｃ、（ＴＣ－ＨＤＬ－Ｃ）／ＨＤＬ－Ｃ值升高可能对亚高原地区冠心病发病更为敏感；冠心病的一级预防重点在于提高体内ＨＤＬ－Ｃ水平，降低ＴＣ水平外，更重要的是调整二者之间的比值。

Objective: To study the effects of ratios of total cholesterol/high density lipoprotein-cholesterol (TC/HDL-C) and total cholesterol - high density lipoprotein-cholesterol/high density lipoprotein-cholesterol [(TC- HDL-C)/HDL-C] on coronary heart disease (CHD)at subhigh altitude, Lanzhou (1517.2 m). Methods: Coronariography was performed in 170 patients with CHD symptoms. CUD was confirmed in 105 patients (CHD group). The other 65 patients were enrolled into control group. TC/HDL-C, (TC- HDL-O/HDL-C ratios and other risk factors were studied in both groups. Results: The abnormal ratios of TC/HDL-C and (TC- HDL-C)/HDL-C were significantly higher in CHD group than those in the control group (38.09% vs. 6.66% and 37.14% vs. 6.66%, p<0.0001). Patients with abnormal ratios of TC/ HDL-C and (TC- HDL-O/HDL-C had seven times increased risk for suffering from CHD (odds ratio>7.0). Conclusions: Besides high TC and low HDL-C concentrations, the ratios of TC/HDL-C and (TC- HDL-O/HDL-C are the most risk factors in developing CHD. They can be used as predictive indices for CHD at subhigh altitude.