HDL-C及其亚型与冠心病患者预后关系的相关性研究

A Study on the Relationship between HDL-C Subtypes and Prognosis of Patients with Coronary Heart Disease

目的:探讨高密度脂蛋白胆固醇(HDL-C)及其亚型与冠心病患者预后的关系。方法:选取2012年6月~2015年12月在我院检查的371例疑似冠心病患者为研究对象,其中确诊为冠心病患者274例为观察组,冠状动脉检查正常者97例为对照组。对两组患者的血脂指标进行检测,同时分析各终点事件与血脂各指标之间的相关性,并采用COX回归分析探讨HDL-C及其亚型与冠心病患者预后的关系。结果:与正常组比较,冠心病患者总胆固醇、低密度脂蛋白胆固醇等指标显著升高,而高密度脂蛋白胆固醇及其亚型HDL2-C显著降低。这种改变随冠状动脉病变支数的增加而更加显著。COX回归分析显示HDL2-C亚型与患者心源性死亡的发生风险存在一定的相关性。结论:HDL2-C亚型与冠心病的发生、发展,患者病变程度存在显著的相关性,可以用作对冠心病患者病情程度和终点事件预测的重要参考指标。

Objective： To investigate the relationship between high-density lipoprotein cholesterol（HDL-C） and its subtypes and the prognosis of patients with coronary heart disease. Methods： 371 suspected patients with coronary artery disease checked in our hospital from Jun 2012 to Dec 2015 were involved in this study. Among them, 274 cases of coronary heart disease patients were classified as observation group. Meanwhile, 97 patients with normal coronary artery were selected as control group. The blood lipid indexes of two groups were detected, and the relationship between HDL-C and its subtypes and the prognosis of patients with coronary heart disease was analyzed by COX regression analysis. Results： Compared with the control group, the levels of total cholesterol and low-density lipoprotein cholesterol in observation group were significantly increased, while HDL-cholesterol and its subtype HDL2-C were significantly decreased. This change is more significantly with the increased in the number of coronary lesions. The COX regression analysis showed that the HDL2-C subtypes had a certain correlation with the risk of cardiac death in patients and can be used to predict the risk of a cardiac event. Conclusions： The high density lipoprotein cholesterol subtypes has a significant correlation with the occurrence, development and pathological changes severity of the coronary heart disease. It can be used as an important reference indicator for predicting the extent of disease and the end events of the patients with coronary heart disease.