高血压前期患者血脂与冠状动脉粥样硬化的相关性

Blood lipids and coronary atherosclerosis in patients with prehypertension

目的探究高血压病前期(pre-hypertension,Pre-HP)患者不同性别间血脂与冠状动脉粥样硬化的相关性及发生冠状动脉粥样硬化的独立危险因素。方法本研究入选2012年12月~2015年4月延安大学附属医院年龄45~75岁且行冠状动脉造影的Pre-HP患者116(男73,女43)例。根据冠状动脉造影结果将其分为冠状动脉粥样硬化组(动脉硬化组)及正常对照组,比较两组间基线特征。并依据血脂水平分组,比较不同性别患者中血脂异常组与正常组的Gensini评分。并通过Logistic回归分析动脉硬化发生的相关因素。结果基线资料对比发现总体患者中动脉硬化组平均年龄及LDL-C较正常对照组高,吸烟史、糖尿病病史及冠心病家族史所占比例较正常对照组高,差异均具有统计学意义(P<0.05);男性组患者中,动脉硬化组较正常对照组年龄及LDL-C高,动脉硬化组糖尿病、吸烟史发生比例较正常对照组高,差异均具有统计学意义(P<0.05);女性组患者中,动脉硬化组平均年龄及LDL-C较正常对照组高,冠心病家族史发生比例较正常对照组高,差异均具有统计学意义(P<0.05)。不同性别中不同血脂的冠脉造影Gensini评分发现男性患者LDL-C-组及TC-组较LDL-C+组及TC+组患者Gensini评分升高(+示异常,-示正常),差异有统计学意义(P<0.05)。logistic回归分析发现年龄、LDL-C为发生动脉硬化的相关因素。结论 Pre-HP男性患者LDL-C、TC升高更易发生动脉硬化。年龄、LDL-C为Pre-HP患者发生动脉硬化的相关因素。

AIM To investigate the correlation between blood lipids and coronary atherosclerosis （CA） in prehypertensive patients of both genders and the independent risk factors of CA. METHODS A total of 116 patients with prehypertension （73 males and 43 females, average age 40 -75 years） were divided into CA group and normal group according to the results of coronary angiography. Baseline characteristics were compared between groups. Grouped by blood lipid levels, Gensini score was compared between patients of both genders. Logistic regression analysis was performed for the independent relevant factors of CA. RESULTS Age, LDL-C, smoking, diabetes mellitus and family history of coronary heart disease in CA group were significantly higher than in the normal group. The same differences, except family history of coronary heart disease, were also found in male patients. In female patients, statistical differ- ences were found in age, LDL-C and family history of coronary heart disease. According to Gensini scores, elevated LDL-C and high cholesterol （TC） were found in male patients. Regression analysis showed that age and LDL-C were independent relevant factors of CA. CONCLUSION LDL-C and TC increase coronary atherosclerosis in male prehypertensive patients. Age and LDL-C are independentrelevant factors of CA in prehypertensive patients.