冠心病患者血清小而密低密度脂蛋白胆固醇和脂蛋白(α)水平变化与冠状动脉病变的相关性

The correlation between serum levels of sdLDL-C and Lp(α)and coronary artery disease in coronary heart disease patients

目的探讨冠心病(CHD)患者血清小而密低密度脂蛋白胆固醇(sdLDL-C)、脂蛋白(α)[Lp(α)]水平变化与CHD临床类型及冠状动脉病变的相关性.方法选取因胸痛入院的患者180例,根据冠状动脉造影结果分为对照组48例,CHD组132例,其中包括稳定型心绞痛(SAP)组41例,不稳定型心绞痛(UAP)组51例,急性心肌梗死(AMI)组40例;根据冠状动脉造影病变支数又分为对照组48例、单支组44例及多支组88例.分别测定患者血清sdLDL-C、Lp(α)及其他血脂指标.结果CHD组血清sdLDL-C、Lp(α)结果分别为(390.22±163.63)mg/L、(31.82±26.89)mg/dl,较对照组差异均有统计学意义(P<0.05);其中SAP组、UAP组、AMI组血清sdLDL-C结果分别为(378.99±174.87)mg/L、(432.03±172.18)mg/L、(376.09±215.26)mg/L,UAP组较SAP组、AMI组差异均有统计学意义(P<0.05);UAP组、AMI组血清Lp(α)结果分别为(28.09±26.15)mg/dl、(33.39±26.82)mg/dl,AMI组较UAP组差异有统计学意义(P<0.05);两者水平均表现为多支组>单支组>对照组(P<0.05).Logistic回归分析表明,血清sdLDL-C和Lp(α)水平是CHD的独立危险因素(0R=9.584、0.962;95%CI 0.996~,11.702、0.930~0.995).结论血清sdLDL-C、Lp(α)水平变化与CHD的临床类型及冠状动脉病变程度相关,可作为CHD的独立危险因素.

Objective To explore the correlation between serum levels of small dense lipoprotein-cholesterol(sdLDL-C)and lipoprotein(α)[Lp(α)]and clinical types and coronary artery disease.Methods 180 patients admitted for coronary angiography surgery due to chest pain were selected.All patients were divided into control group with 48 cases and coronary heart disease(CHD)group with 132 cases by coronary angiography;CHD group included stable angina pectoris(SAP)41 cases,unstable angina pectoris(UAP)51 cases and acute myocardial infarction(AMI)40 cases.According to the lesions severity of coronary artery,the patients were divided into control group(48 cases),single vessel lesion group(44 cases)and multi-vessel lesions group(88 cases).The sdLDL-C and Lp(α)level and other blood lipid indexes were determined respectively.Results The sdLDL-C and Lp(α)in CHD group were(390.22±163.63)mg/L and(31.82±26.89)mg/dl,which were higher than control group(P<0.05).The sdLDL-C of SAP group,UAP group and AMI group were(378.99±174.87)mg/L,(432.03±172.18)mg/L and(376.09±215.26)mg/L respectively;there were significant differences between UAP group and SAP group and AMI group(P<0.05).The Lp(α)of UAP and AMI group were(28.09±26.15)mg/dl and(33.39±26.82)mg/dl;there was significant difference between AMI group and UAP group(P<0.05).The levels of sdLDL-C and Lp(α)both showed multi-vessel lesion group>single-vessel lesion group>control group.Logistic regression analysis indicated that sdLDL-C and Lp(α)were independent risk factors for CHD(OR=9.584,0.962;95%C/0.996-11.702,0.930-0.995).Conclusion The level changes of sdLDL-C and Lp(α)can reffect the clinical type and the degree of coronary artery disease,which can be used as an independent risk factor for CHD.