高血压前期患者血脂与冠状动脉粥样硬化的相关性

Correlation between blood lipid and coronary atherosclerosis in patients with pre-hypertension

目的探讨高血压前期(pre-hypertension,Pre-HP)患者血脂与冠状动脉粥样硬化(coronary atherosclerosis,CA)的相关性。方法入选2013年3月至2014年4月在沈阳军区总医院住院行冠状动脉造影的230例Pre-HP[收缩压(systolic blood pressure,SBP)在120~139 mm Hg(1 mm Hg=0.133 k Pa)或舒张压(diastolic blood pressure,DBP)在80~89 mm Hg]患者,年龄在(56.79±7.60)岁,根据冠状动脉造影结果分为两组:冠状动脉粥样硬化性心脏病(coronary atherosclerotic heart disease,CAD)组为病变狭窄≥50%;对照组为病变狭窄<50%。CA程度应用Gensini评分评定,对常见危险因素与CA程度的相关性分析应用Pearson或Spearman相关性分析方法,通过Logistic回归分析方法判断血脂与CA程度的独立相关性。结果 CAD组与对照组年龄、DBP、吸烟率、糖尿病患病率、冠心病家族史、血糖、高密度脂蛋白固醇(high-density lipoprotein cholesterol,HDL-C)比较,差异有统计学意义(P<0.05)。Gensini评分与年龄、SBP、DBP、血糖、吸烟、糖尿病患病率、CHD家族史,HDL-C、低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)及总胆固醇相关(P<0.05)。亚组性别分析显示,在女性中,Gensini评分与总胆固醇呈正相关,与HDL-C呈负相关(P<0.05);在男性中,与Gensini评分呈正相关的是LDL-C(P<0.05)。Logistic回归分析显示,校正其他因素的影响后,年龄、吸烟、血糖是CA病变程度独立危险因素(P<0.05);但是血脂与CA的程度并无相关性。亚组分析:女性的HDL-C、总胆固醇及男性的LDL-C均与血糖及血压密切相关(P<0.05)。结论 Pre-HP患者中,HDL-C、LDL-C及总胆固醇与CA相关;血脂是通过与血糖、血压代谢调节相互作用,进而与CA相关。

Objectives To study the correlation between blood lipid and coronary atherosclerosis in patients withpre-hypertension（Pre-HP）.Methods This study enrolled a total of 230 Pre-HP patients,aged（56.79±7.60）years,from March 2013 to April 2014.All participants presented to the The General Hospital of Shengang Millitary Commandwith a diagnosis of Pre-HP [systolic blood pressure（SBP）ranged 120-139 mm Hg（1 mm Hg=0.133 k Pa） ordiastolic blood pressure ranged（DBP）ranged the 80-89 mm Hg].According to coronary angiographic results,allthe patients were divided into two groups：coronary atherosclerotic heart disease（CAD）group for stenosis≥50%;control group for stenosis 50%.The severity of coronary atherosclerosis was evaluated by Gensini score.Thecorrelation between the severity of coronary atherosclerosis and the common risk factors of coronary atherosclerosiswas analyzed by Pearson or Spearman correlation analysis methods.The Logistic regression analysis was used toanalyze whether the correlation of blood lipid and coronary atherosclerosis was independence.Results Comparedwith baseline data,the obviously different distribution in the two groups were age,DBP,smoking rate,prevalence ofdiabetes,family history of coronary heart disease,blood glucose and high-density lipoprotein cholesterol（HDL-C）（P〈0.05）.In correlation analysis,Gensini score related to age,SBP,DBP,HDL-C,low-density lipoprotein cholesterol（LDL-C）,total cholesterol（TC）,blood glucose,smoking,diabetes prevalence rate and the family history of coronaryheart disease（P〈0.05）.In women,Gensini score positively correlated with TC,and negatively correlated withHDL-C（P〈0.05）;while in men,Gensini score positively correlate with LDL-C（P〈0.05）.Logistic regression analysisshowed after adjusting the influence of other factors,age,smoking and blood glucose still independently associatedwith severity of coronary atherosclerosis（P〈0.05）,but no correlation between lipids and coronary atheroscleroticlesions was showed.At the same time,HDL-C and TC in women and LDL-C in men associated with blood pressureand blood glucose（P〈0.05）.Conclusions HDL-C,LDL-C and TC correlate with coronary atherosclerosis in pa-tients with Pre-HP through metabolic regulation of blood pressure and blood glucose.