老年高水平高密度脂蛋白胆固醇冠心病患者冠脉病变的回顾性分析

Retrospective Analysis of Coronary Lesion Risk Factors in an Elderly Coronary Heart Disease with High Level High Density Lipid Cholesterol

【目的】回顾性分析老年高水平高密度脂蛋白胆固醇（HDL-C）患者冠脉狭窄情况。【方法】搜集2013年01月至2015年03月在中山大学孙逸仙纪念医院心内住院的老年冠心病患者329例,年龄60-80岁,无他汀类药物使用史,均行冠脉造影,按照HDL-C水平分为3组,低水平HDL-C组（〈1.04 mmol/L）,正常水平HDL-C组（1.04~1.54 mmol/L）,高水平HDL-C组（〉1.55 mmol/L）,对3组资料一般情况、血脂生化、冠脉病变进行回顾性分析,所有统计采用SPSS18.0。【结果 】1高水平HDL-C组中,女性百分比、年龄、TC、HDL-C、HDL/LDL、Apo A1、Apo A1/Apo B水平显著高于正常水平HDL-C组和（或）低水平HDL-C组（P〈0.05）;而BMI、心梗史、吸烟史、TG、C-反应蛋白（CRP）显著低于正常水平HDL-C组和（或）低水平HDL-C组（P〈0.05）;2高水平HDL-C组,单支冠脉病变显著高于低水平HDL-C组;而三支病变显著低于低水平HDLC组（P〈0.05）。【结论 】老年高水平高密度脂蛋白胆固醇冠心病患者主为年龄偏大女性为主,单支冠脉病变显著高于低水平HDL-C组;三支冠脉病变显著低于低水平HDL-C组。

[ Objectives] Retrospective analyze the risk factors of coronary lesion in an elderly coronary heart disease （CHD） cohort with high HDL-C level. [ Methods ] 329 elderly CHD patients by receiving coronary angiography, aged between 60 and 80 years old, no history of statin therapy, recruited from January, 2013 to March, 2015, were selected from Sun Yat-sen Memorial Hospital. The patients were divided into 3 groups according to the level of HDL-C, which were designed low level HDL-C group （below 1.04 mmol/L）, normal level HDL-C group （HDL-C level between 1.04 and 1.54 mmol/L） and high level HDL-C group （HDL-C level above 1.55 mmol/L）. Retrospective analysis was performed within the three groups of general information , Biochemical information , Coronary lesion and all the data were analyzed by SPSS 18.0. [ Results ] ① In high level HDL-C group, the percentage of female patients, age, TC, HDL, HDL/LDL, ApoA1 and ApoA1/ApoB level were significantly higher than normal level HDL-C group and （or） low level HDL-C group （P 〈 0.05） ; however, when compared to normal level HDL-C group and （or） low level HDL-C group, the index of BMI, history of Myocardial Infarction, history of smoking, TG, C-reaction protein （CRP） were significantly lower in high HDL-C group （P 〈 0.05）;②In high level HDL-C group, one-vessel coronary lesion is significantly higher than low level HDL-C group; however, the three-vessel coronary lesion is significantly lower than low level HDL-C group （P〈0.05）. [Conclusions] In high level HDL-C, most of the patients are elderly women ; compare to low level HDL-C group, in high level HDL-C group, one-vessel coronary lesion is significantly higher, but three-vessel coronary lesion is significantly lower.