冠心病的发病年龄与脂蛋白颗粒的相关性研究

Correlation Study Between Lipoprotein Subfraction and Different Onset Age of Coronary Heart Disease

目的:探讨冠心病的发病年龄与脂蛋白颗粒的相关性。方法:连续收集1 217例经冠状动脉造影证实的冠心病患者,根据发病年龄分为早早发组(n=135例,≤45岁)、早发组(n=505例,男性:46~55岁;女性:46~65岁)和迟发组(n=577例,男性>55岁,女性>65岁),同时入选一组冠状动脉造影正常者作为对照组(n=72例,≤45岁)。随后应用Lipoprint脂蛋白分类检测仪对脂蛋白进行分类,分析不同大小颗粒[包括高密度脂蛋白(HDL)颗粒和低密度脂蛋白(LDL)颗粒]在上述四组患者中的分布情况,探讨HDL颗粒与早早发冠心病的相关性。结果:早早发组冠心病患者大HDL颗粒减少,同时小LDL颗粒增加(P<0.05)。Logistic回归分析发现,大HDL颗粒和早早发冠心病呈负相关(OR=0.872,95%CI:0.825~0.922),而小LDL颗粒与其呈正相关(OR=1.038,95%CI:1.008~1.069)。而进一步行多因素Logistic回归分析后,仅大HDL颗粒和早早发冠心病显著负相关(OR=0.899,95%CI:0.848~0.954)。结论:大HDL颗粒和早早发冠心病呈显著负相关,提示其在早早发冠心病的发病过程中起一定的作用。

Objective： To clarify correlation between lipoprotein subfraction and different age of coronary heart disease. Methods： A total of 1217 patients with coronary angiography （CAG） confirmed CAD were consecutively enrolled. According to onset age, the patients were divided into 3 groups： Very early CAD group, n=135 patients, ≤45 years, Early CAD group, n=505 patients, male at （45-55） years and female at （45-65） years, Late CAD group, n=577 patients, male〉55 years and female〉65 years. Meanwhile, there was a Control group, n=72 subjects, ≤45 years with normal CAG. The Lipoprotein system was used to classify lipoprotein subfractions and to analyze the distributions of different particles of high-density lipoprotein （HDL） subfraction and low-density lipoprotein （LDL） subfraction in above 4 groups; to explore the relationship between HDL subfraction and very early CAD occurrence. Results： Compared with other groups, Very early CAD group had decreased large particle of HDL subfraction and increased small particle of LDL subfraction, P〈0.05. Logistic regression analysis found that the large particle of HDL subfraction was negatively related to very early CAD occurrence （OR=0.872, 95% CI 0.825-0.922）, small particle of LDL subfraction was positively related to very early CAD occurrence （OR=1.038, 95% CI 1.008-1.069）. Further multivariate Logistic regression analysis indicated that only large particle of HDL subfraction was obviously negatively related to very early CAD occurrence （OR=0.899, 95% CI 0.848-0.954）. Conclusion： Large particle of HDL subfraction was negatively related to very early CAD occurrence which implied it played an important role in very early CAD process.