冠心病患者FFA水平与冠脉病变程度的相关性分析

The Correlation of FFA Level with the Severity of Coronary Artery Lesions in Patients with Coronary Heart Disease

目的探讨冠心病(CHD)患者游离脂肪酸(FFA)水平与冠脉病变程度的关系。方法选取我院接诊的具备完整病例资料的433例CHD患者为研究对象,另纳入我院同期健康体检者90例为对照组,比较不同类型、冠脉不同狭窄支数和不同冠脉病变Gensini积分CHD患者的FFA水平,分析FFA与冠脉病变程度的相关性。结果 CHD组与对照组甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、载脂蛋白A1(APOA1)、FFA比较,差异均有统计学意义(P<0.05),不稳定型心绞痛(UAP)、稳定型心绞痛(SAP)和急性心肌梗死(AMI)组FFA水平均显著高于对照组(P<0.05),UAP组和SAP组FFA水平比较,差异无统计学意义(P>0.05);AMI组FFA水平显著高于UAP组和SAP组(P<0.05);FFA水平随着冠脉狭窄支数和冠脉病变Gensini积分的增加而升高(P<0.05);FFA水平与冠脉病变Gensini积分呈正相关(r=0.309,P<0.05);FFA水平与冠脉狭窄支数呈正相关(r=0.265,P<0.05);FFA>0.57mmol/L是冠脉病变的独立危险因素。结论 CHD患者FFA水平与冠脉病变Gensini积分、冠脉狭窄支数呈正相关,FFA>0.57mmol/L是冠脉病变的独立危险因素,治疗过程中应监测和控制FFA水平。

Objective To investigate the relationship between the level of free fatty acids （FFA） and the severity of coronary artery lesions in patients with coronary artery disease （CHD）. Methods 433 patients with CHD and complete medical records in our hospital were selected as study subjects, and 90 healthy people undergoing physical examination in our hospital were selected as control group at the same time. The FFA levels were compared between patients with different types. Different coronary stenosis counts and different Gensini scores of CHD, and the correlation of FFA level with the severity of coronary artery lesions in patients with CHD was analyzed. Results There were significant differences between CHD group and control group in triglyceride （ TG）, high- density lipoprotein cholesterol （ HDL- C）, apolipoprotein A1 （ APOA1 ） and FFA （ P 〈 0.05 ）. FFA levels in the unstable angina pectoris （UAP） group, stable angina pectoris （SAP） group and acute myocardial infarction （AMI） group were higher than those in control group （ P 〈 0.05 ）, but there was no significant difference between UAP group and SAP group （ P 〉 0. 05 ）. FFA levels in AMI group were significantly higher than those in UAP group and SAP group （ P 〈 0.05 ）. The level of FFA increased with the increase of coronary stenosis count and Gensini score of coronary artery lesions （ P 〈 0.05 ）. The FFA level was positively correlated with Gensini scores of coronary artery lesions （ r = 0. 309, P 〈 0.05 ） and the coronary stenosis count（ r = 0.265 ,P 〈 0.05 ）. FFA level 〉 0.57mmol/L was an independent risk factor for coronary artery lesions. Conclusion The FFA level in patients with CHD is positively correlated with the Gensini score of coronary artery lesions and the number of coronary stenosis. FFA 〉 0.57mmol/L is an independent risk factor of coronary artery lesions, and the level of FFA should be monitored and controlled during the treatment.