非糖尿病急性冠脉综合征住院患者HDL-C、LDL-C/HDL-C水平回顾性分析

Retrospective Analysis on HDL-C and LDL-C / HDL-C Level in Non-diabetic Acute Coronary Syndrome Patients

【目的】回顾性分析非糖尿病急性冠脉综合征HDL-C、LDL-C/HDL-C水平及冠脉病变相关性。【方法】选择本院2011.05-2015.05住院符合急性冠脉综合征诊断标准并无2型糖尿病患者306例为研究对象,选择同期住院符合急性冠脉综合征诊断标准并确诊为2型糖尿病患者174例,以及冠脉造影正常无糖尿病患者258例为对照,所有患者均行冠状动脉造影检查。将前降支、回旋支或右冠脉中任何一支狭窄≥50%为单支病变组;前降支、回旋支或右冠脉中任何两支病变≥50%及左主干病变为双支病变组;将前降支、回旋支和右冠状动脉三支病变均≥50%或左主干合并右冠脉病变为多支病变组。搜集临床资料及生化血脂指标,采用SPSS18.0进行统计分析。【结果】1非糖尿病急性冠脉综合征组和2型糖尿病急性冠脉综合征组,HDL-C水平均低于冠脉正常组,而LDL-C/HDL-C均高于冠脉正常组(P<0.05);2非糖尿病急性冠脉综合征患者中,冠脉双支病变组、多支病变组HDL-C水平均低于单支病变组(P<0.05);而多支病变组LDL-C/HDL-C均显著高于单支病变组、双支病变组(P<0.05)。3非糖尿病急性冠脉综合征患者冠脉病变支数与HDL-C水平呈负相关(r=-0.199,P<0.001),与LDL-C/HDL-C水平呈正相关(r=0.184,P=0.001)。【结论】低HDL-C、高LDL-C/HDL-C可作为冠心病预测指标之一。非糖尿病急性冠脉综合征患者冠脉病变严重程度与HDL-C、LDL-C/HDL-C密切相关。

【Objectives】 To retrospectively analyze the correlation on HDL-C, LDL-C / HDL-C level and coronary lesions in nondiabetic acute coronary syndrome（ACS） subjects. 【Methods】 306 patients which hospitalized in Cardiology Department of Sun Yatsen Memorial Hospital of Sun Yat-sen University from May 2011 to May 2015 with diagnosed acute coronary syndrome（ACS） and without type 2 diabetes mellitus were recruited as Non-diabetic ACS group, another 174 patients which hospitalized and were diagnosed with acute coronary syndrome with type 2 diabetes mellitus as diabetic ACS group and 258 subjects with normal coronary angiography and non-type 2 diabetes mellitus in the same period as control group were also recruited. All subjects were acceptedcoronary angiography examination on coronary artery. According to the coronary angiography results, only one vessel of the left anterior descending artery（LAD）, left circumflex artery（LCX） or right coronary artery（RCA） stenosis was above 50% were selected as single-vessel？ lesion group, and patients that confirmed two vessels of the LAD, LCX, RCA or left main coronary artery obstructive were selected as two-vessel lesion group, patients that showed three of LAD, LCX, RCA or two of left main coronary artery and right coronary artery obstructive were selected as multi-vessel lesion group. All the data were analyzed by SPSS18.0. 【Results】（1）Compared with control group, the HDL-C level was significantly decreased, and LDL-C / HDL-C was significantly increased both in Non-diabetic ACS group and diabetic-ACS group（P〈0.05, respectively）;（2） In non-diabetic ACS subjects, the HDL-C level was significantly decreased in two-vessel lesions group and multi-vessel lesions group than that in single-vessel lesions group（P〈0.05, respectively）. However, the LDL-C / HDL-C were significantly increase in single-vessel lesion group and two-vessel lesion group than that in multi-vessel lesions group（P〈0.05）;（3） In non-diabetic ACS group, the artery stenosis vessel number was inversely correlated with HDL-C level（r =-0.199, P 〈0.001）, but positively correlated with LDL-C / HDL-C level（r = 0.184, P〈 0.001）. 【Conclusions】 In non-diabetic ACS patients, both HDL-C and LDL-C / HDL-C might be the indicators of coronary disease.Low HDL-C level and high LDL-C / HDL-C might play an important role in the severity of coronary lesion.