绝经前后女性冠心病患者HDL及LDL颗粒与冠状动脉病变程度的相关性研究

Correlation between HDL,LDL particles and coronary artery lesions in premenopausal and postmenopausal female patients with coronary artery disease

目的探讨绝经前后女性冠心病患者高密度脂蛋白(HDL)颗粒及低密度脂蛋白(LDL)颗粒与冠状动脉病变程度的关系。方法收集经冠状动脉造影确诊的女性冠心病患者79例,根据是否绝经分为绝经前组(n=37)和绝经后组(n=42)。Lipoprint脂蛋白分析仪对HDL颗粒及LDL颗粒进行检测分析,探讨两种脂蛋白颗粒与冠状动脉病变程度的关系。结果与绝经前组比较,绝经后组大颗粒HDL浓度(102.6±45.2 mg/L比143.8±49.7 mg/L,P<0.05)及所占比例(23.34%±8.26%比31.15%±7.98%,P<0.05)、LDL颗粒平均直径(259.5±8.1比265.7±3.7,P<0.05)均降低,小颗粒HDL浓度(124.0±76.8 mg/L比87.0±34.9 mg/L,P<0.05)及所占比例(27.26%±12.34%比18.62%±6.53%,P<0.05)、LDL B型比例(73.8%比48.6%,P<0.05)、Gensini积分(50.88±26.46比30.43±18.54,P<0.05)均增高。绝经前组及绝经后组多支病变患者大颗粒HDL浓度、LDL颗粒平均直径均低于单支病变患者,Gensini积分高于单支病变患者;绝经后组大颗粒HDL浓度、LDL颗粒平均直径均低于绝经前组,小颗粒HDL所占比例及Gensini积分高于绝经前组。绝经前组和绝经后组LDL颗粒大小及大颗粒HDL浓度均与Gensini积分呈负相关。结论与绝经前组相比,绝经后组大颗粒HDL浓度较低,小颗粒HDL浓度较高,LDL颗粒平均直径较小,冠状动脉病变程度较严重;大颗粒HDL浓度及LDL平均直径与冠状动脉病变严重程度明显相关。

Aim To explore the relationship between high density lipoprotein（ HDL） particle,low density lipoprotein（ LDL） particle and coronary artery lesions in premenopausal and postmenopausal female patients with coronary artery disease. Methods Data were collected from 79 female patients with coronary artery disease diagnosed by coronary angiography. According to whether menopause,the patients were divided into premenopausal group（ n = 37） and postmenopausal group（ n = 42）. HDL particles and LDL particles were detected and analyzed by Lipoprint lipoprotein analyzer.The relationship between two lipoprotein particles and severity of coronary artery lesions was studied. Results Compared with the premenopausal group,large particle HDL concentration（ 102.6±45.2 mg/L vs 143.8±49.7 mg/L,P〈0. 05）and its proportion（ 23.34% ±8.26% vs 31.15% ±7.98%,P〈0.05）,and mean diameter of LDL particles（ 259.5±8. 1 vs265.7±3.7,P〈0.05） were decreased,small particle HDL concentration（ 124.0±76.8 mg/L vs 87.0± 34.9 mg/L,P 0.05） and its proportion（ 27.26% ±12.34% vs 18.62% ±6.53%,P〈0.05）,B type proportion in LDL（ 73. 8% vs 48. 6%,P〈0.05）,and Gensini score（ 50.88±26.46 vs 30.43± 18.54,P 0.05） were increased,in the postmenopausal group. In premenopausal group and postmenopausal group,large particle HDL concentration and the average diameter of LDL particles in patients with multivessel lesions were lower than those in patients with single vessel lesions,and the Gensini score was higher than that in patients with single vessel lesions. Large particle HDL concentration and the average diameter of LDL particles in postmenopausal group were lower than those in premenopausal group,and small particle HDL proportion and Gensini score in postmenopausal group were higher than those in premenopausal group. LDL particle size and large particle HDL concentration were negatively correlated with the Gensini score in the premenopausal group and the postmenopausal group. Conclusion Compared with the premenopausal group,large particle HDL concentration is lower,small particle HDL concentration is higher,the average diameter of LDL particle is smaller,and the degree of coronary artery lesions is more serious in the postmenopausal group. Large particle HDL concentration and the mean diameter of LDL are significantly correlated with the severity of coronary artery lesions.