低密度脂蛋白正常者冠心病危险因素分析

Risk Factors of Coronary Heart Disease in Individuals with Normal LDL

目的分析低密度脂蛋白(LDL)正常者冠心病的危险因素。方法选取2013—2014年上海交通大学医学院附属第九医院心内科住院患者108例,根据定量冠状动脉造影(QCA)检查结果分为对照组54例(冠状动脉狭窄率<50%)和冠心病组54例(冠状动脉狭窄率タ50%)。收集所有患者临床资料,分析LDL正常者冠心病的危险因素。结果两组患者性別、年龄、心率、身高、体质量、腰臀比(WHR)、收缩压(SBP)、舒张压(DBP)、总胆固醇(TC)、三酰甘油(TG)、LDL、载脂蛋白B(ApoB)、载脂蛋白Al(ApoAl)、空腹血糖、肌酐、尿酸比较,差异无统计学意义(P>0.05);冠心病组患者高密度脂蛋白(HDL)低于对照组,糖化血红蛋白(HbA_(1c)及超敏C反应蛋白(hs-CRP)高于对照组(P<0.05)。Spearman相关性分析结果显示,HbA_(1c)(r=0.238,P=0.013)、hs-CRP(r=0.213,P=O.027)与LDL正常者冠心病发生率呈正相关,而HDL与LDL正常者冠心病发生率呈负相关(r=-0.191,P=O.047)。多因素Logistic回归分析结果显示,HbA_(lc)(OR=1.880,95%CI(1.119,3.159)]、hs-CRP[OR=1.061,95%CI(1.003,1.122)]是LDL正常者冠心病的危险因素(P<0.05)。结论 LDL正常者冠心病发生率较局,HbA_(1c)、hs-CRP是LDL正常者冠心病的危险因素。

Objective To analyze the risk factors of coronary heart disease in individuals with normal LDL. Methods From 2013 to 2014,a total of 108 inpatients were selected in the Department of Cardiology, the Ninth Affiliated Hospital of School of Medicine, Shanghai Jiaotong University, and they were divided into control group （ with coronary artery stenosis rate less than 50% ） and observation group （ with coronary artery stenosis rate equal or over 50% ） according to quantitative coronary angiography （QCA） examination results, each of 54 cases. Clinical data of all the patients was collected, and risk factors of coronary heart disease in individuals with normal LDL was analyzed. Results No statistically significant differences of gender, age, heart rate, height, body mass, WHR, SBP, DBP, TC, TG, LDL, ApoB, ApoAl, FBG, Cr or UA was found between the two groups （P 〉 0. 05） ; HDL of observation group was statistically significantly lower than that of control group, while HbAlc and hs - CRP of observation group were statistically significantly higher than those of control group （ P 〈 0. 05 ）. Spearman correlation analysis results showed that, HbAlc （ r =0.238, 0.013） and hs - CRP （ r =0.213, 0.027） waspositively correlated with incidence of coronary heart disease in individuals with normal LDL, respectively, while HDL was negatively correlated with incidence of coronary heart disease in individuals with normal LDL （ r = -0. 191,P = 0. 047 ）. Multivariate logistic regression analysis results showed that, HbAy [ OR = 1. 880, 9 5 % Cl （1. 119, 3. 159） ] and hs - CRP [OR = 1. 061, 95% Cl （1.003, 1. 122）] were risk factors of coronary heart disease in individuals with normal LDL （P 〈0 . 05）. Conclusion The incidence of coronary heart disease is relatively high in individuals with normal LDL, meanwhile HbAlc and hs - CRP are risk factors of coronary heart disease in individuals with normal LDL.