血清总胆固醇与高密度脂蛋白胆固醇比值作为冠心病危险标志的意义

Significance of serum total cholesterol to high density lipoprotein cholesterol ratio as a risk marker for coronary heart disease

目的分析冠心病(CHD)患者的血脂水平,探讨血清总胆固醇(TC)与高密度脂蛋白胆固醇(HDL-C)比值作为CHD危险标志的临床意义。方法测定295例CHD患者的血清TC、三酰甘油(TG)、HDL-C及低密度脂蛋白胆固醇(LDL-C)水平,并计算TC/HDL-C比值。结果依据《中国成人血脂异常防治指南》颁布的血脂水平合适范围,CHD患者血清TC、TG及LDLC高于合适范围百分率分别为32.20%、34.24%及37.63%,血清HDL-C低于合适范围百分率为39.32%。血清TC/HDL-C比值高于合适范围百分率为57.29%。血清TC/HDL-C比值异常率显著高于血清TC、TG、HDL-C及LDL-C(χ2=37.540、31.576、19.066、22.866,P<0.01)。结论与任一单项血脂检测相比,血清TC/HDL-C比值作为CHD危险标志可能更有临床意义,临床血脂检测报告单应增加TC/HDL-C比值。

Objective To analyze blood lipid levels in patients with coronary heart disease,and to explore clinical significance of serum total cholesterol to high density lipoprotein cholesterol ratio as a risk marker for coronary heart disease.Methods Serum levels of total cholesterol,triglycerides,high density lipoprotein cholesterol,and low density lipoprotein cholesterol were measured for295 patients with coronary heart disease.Ratio of total cholesterol to high density lipoprotein cholesterol was calculated based on the lipid tests.Results The percentages of abnormal total cholesterol,triglycerides,high density lipoprotein cholesterol,and low density lipoprotein cholesterol were 32.20%、34.24%,39.32%,and 37.63%,respectively,for patients with coronary heart disease according to normal ranges issued by Guidelines on Prevention and Treatment of Dyslipidemia in Adults in Chinese Population.The abnormal percentage of total cholesterol to high density lipoprotein cholesterol ratio was 57.29%.The percentage of raising total cholesterol to high density lipoprotein cholesterol ratio was significantly higher than abnormal ratios of total cholesterol,triglycerides,high density lipoprotein cholesterol,and low density lipoprotein cholesterol for patients with coronary heart disease（χ^2=37.540,31.576,19.066,22.866;P〈0.01）.Conclusion Comparing to any blood lipid test,total cholesterol to high density lipoprotein cholesterol ratio is a marker that helps us estimate the risk of developing coronary heart disease.Ratio of total cholesterol to high density lipoprotein cholesterol may be as a test estimating the risk of developing coronary heart disease.