非高密度脂蛋白胆固醇与冠心病患者心功能分级的相关性研究

Correlation between Non High Density Lipoprotein Cholesterol and Cardiac Function in Patients with Coronary Heart Disease

目的探讨非高密度脂蛋白胆固醇（non-HLD-C）与冠心病（cardiac heart disease，CHD）患者心功能分级的相关性。方法选取162例CHD患者为CHD实验组，并同期选取经健康体检合格者100例为正常对照组。CHD实验组按照心功能受损程度分为轻度受损组和重度受损组，其中轻度受损组包括心功能分级的 I级与 II级，重度受损组包括心功能分级的 III级和 IV级。分别测定各组总胆固醇（TC）、三酰甘油（TG）、高密度脂蛋白胆固醇（HDL-C）和低密度脂蛋白胆固醇（LDL-C），并计算出非高密度脂蛋白胆固醇（non-HDL-C）的含量。比较CHD实验组与正常对照组中血脂各指标的差异性及血脂各指标与心功能受损程度的相关性。结果 CHD实验组中心功能轻度受损组血清中的 TG，LDL，non-HDL-C高于正常对照组，两组间差异有统计学意义（t＝2.438，2.887，5.253，P值均＜0.05），CHD实验组中的心功能重度受损组血清中的TG，LDL，non-HDL-C 高于正常对照组中，两组间差异有统计学意义（t＝4.979，4.957，7.190，P 值均＜0.05）， CHD实验组中心功能轻度受损组血清中的 HDL较正常对照组低，两组间差异有统计学意义（t＝-3.132，P＜0.05），CHD实验组中心功能重度受损组血清中的 HDL较正常对照组低，两组间差异有统计学意义（t＝-6.028，P＜0.05），CHD实验组中只有心功能重度受损组的TC与正常对照组间差异有统计学意义（t＝3.278，P＜0.05），CHD实验组中心功能轻度受损组的 LDL，non-HDL-C，TG与重度受损组间差异有统计学意义（t＝2.051，2.057，2.281，P 值均＜0.05）。Logistic回归分析显示，CHD组血清 non-HDL-C的 OR值低于 LDL，高于 HDL和TG，并随着心功能受损程度的增加 OR值增加。结论 non-HDL-C与CHD的严重程度呈正相关，可在一定程度上反映 CHD的严重程度，是 CHD临床诊断与治疗的重要参考指标。

Objective To investigate the correlation between non high density lipoprotein cholesterol （non-HLD-C）and cardi-ac function in patients with coronary heart disease （heart disease cardiac,CHD）.Methods 162 patients with CHD were se-lected as the experimental group of CHD,100 cases of healthy physical examination qualified as the normal control group. CHD experimental group was divided into mild impairment group and severe impairment group according to the degree of impairment of the heart function.The mild impairment group include I and II levels of cardiac function classification and the severe impairment group included III and IV levels of cardiac function classification.To measure separately total cholesterol （TC）,triglyceride （TG）,high density lipoprotein cholesterol （HDL-C）,low density lipoprotein cholesterol （LDL-C）,and to calculate the content of non high density lipoprotein cholesterol （non-HDL-C）.To compare the differences between CHD ex-perimental group and normal control group,and the correlation between different indexes of blood lipid and the degree of loss of cardiac function.Results The serum levels of non-HDL-C,TG and LDL in the Cardiac function in mild damage group of the CHD experimental group were significantly higher than those in the normal control group,and there were statistically significant differences between the two groups（t=2.438,2.887,5.253,P〈0.05）.The serum levels of non-HDL-C,TG and LDL in the severe heart function impairment group of the CHD experimental group were significantly higher than those in the normal control group,and there were statistically significant differences between the two groups （t=2.438,2.887,5.253,P〈0.05）.The serum level of HDL in the cardiac function in mild damage group of the CHD experimental group was significantly lower than that in the normal control group （t=-3.132,P〈0.05）.The serum level of HDL in the severe heart function impairment group of the CHD experimental group was significantly lower than that in the normal control group （t=-6.028,P〈0.05）.In the CHD group,only the serum level of TC in the severe impairment group was signifi-cantly different from that in the control group （t=3.278,P〈0.05）.The serum levels of non-HDL-C,TG,LDL of mild im-pairment of cardiac function in the CHD experimental group were significantly different from the serum levels of the severe impairment group （t=2.051,2.057,2.281,P〈0.05）.Logistic regression analysed that the OR value of serum non-HDL-C in CHD group was slightly lower than that of LDL,and significantly higher than TC and TG.With the increase of the degree of cardiac function,the value of OR increased significantly.Conclusion Serum non-HDL-C had a positive correlation with severity of CHD.To a certain extent,it can reflect the severity of CHD and is an important reference index for clinical diag-nosis and treatment of CHD.