LDL-C/HDL-C与冠状动脉粥样硬化发病关系的队列研究

Cohort study on the relationship between LDL-C/HDL-C ratio and coronary atherosclerosis

目的分析冠心病患者低密度脂蛋白胆固醇(LDL-C)/高密度脂蛋白胆固醇(HDL-C)及其与冠状动脉粥样病变程度和发病的相关性。方法选取2021年5月至2023年2月新乡医学院第一附属医院收治的70例经冠状动脉血管造影确诊为冠心病的患者作为研究对象,根据Gensini积分分为低危组、中危组与高危组。另选取25例非冠心病患者为对照组。比较分析四组患者的一般资料以及LDL-C、HDL-C水平和LDL-C/HDL-C,分析血脂指标与Gensini积分的相关性,分析其对冠状动脉粥样病变严重程度的预测价值。结果四组年龄、性别、吸烟史、高血压病史、合并糖尿病、合并心律失常、冠心病家族史、体质指数、舒张压、收缩压、血红蛋白、血小板计数、糖化血红蛋白比较,差异未见统计学意义(P>0.05),胆固醇(TC)、三酰甘油(TG)、HDL-C、LDL-C、LDL-C/HDL-C、左室射血分数(LVEF)、Gensini积分比较,差异有统计学意义(P<0.05)。Pearson相关性分析显示,冠心病患者HDL-C、LVEF与Gensini积分呈负相关,TC、LDL-C、LDL-C/HDL-C与Gensini积分呈正相关,TC、LDL-C、HDL-C、LVEF、LDL-C/HDL-C指标是影响Gensini积分的因素。以Gensini积分作为因变量,LDL-C/HDL-C、LVEF和LDL-C可明显影响Gensini积分,其中LDL-C/HDL-C能单独影响Gensini积分,对Gensini积分影响大小依次是LDL-C/HDL-C>LVEF>LDL-C。结论TC、LDL-C、HDL-C、LVEF是冠心病患者Gensini积分的关键预测项目。LVEF和HDL-C与Gensini积分呈负相关关系,可保护冠状动脉不发生粥样硬化病变,而LDL-C、TC及LDL-C/HDL-C与Gensini积分呈正相关关系,是冠状动脉发生粥样硬化病变的影响因素。

Objective To analyze the correlation between low density lipoprotein cholesterol(LDL-C)/high density lipoprotein cholesterol(HDL-C)ratio and the degree and incidence of coronary artery disease in patients with coronary heart disease.Methods Seventy patients diagnosed with CHD by coronary angiography from May 2021 to February 2023 in First Affiliated Hospital of the Xinxiang Medical University were selected as study objects,and were divided into low-risk group,medium-risk group and high-risk group according to their Gensini scores.Another 25 patients without coronary heart disease were selected as control group.The general data of patients in each group were compared and analyzed,as well as the relationship between LDL-C,and HDL-C levels,LDL-C/HDL-C ratio and Gensini scores,and their predictive value for the severity of coronary atherosclerosis was analyzed.Results There was no significant difference in age,sex,smoking history,history of hypertension,combined arrhythmia,family history of coronary heart disease,body mass index,diastolic blood pressure,systolic blood pressure,hemoglobin,platelet count and hemoglobin A1c among the four groups(P>0.05).There were significant differences in diabetes mellitus,cholesterol(TC),triglyceride(TG),HDL-C,LDL-C,LDL-C/HDL-C,left ventricular ejection fraction(LVEF)and Gensini score(P<0.05).Pearson correlation analysis showed that HDL-C and LVEF were negatively correlated with Gensini scores in CHD patients,while TC,LDL-C and LDL-C/HDL-C were positively correlated with Gensini scores.TC,LDL-C,HDL-C,LVEF,LDL-C/HDL-C indexes were the factors affecting Gensini scores.Taking Gensini integral as the dependent variable,LDL-C/HDL-C,LVEF and LDL-C can significantly affect Gensini integral,in which LDL-C/HDL-C ratio can independently affect Gensini integral.The order of influence on Gensini integration was LDL-C/HDL-C ratio>LVEF>LDL-C.Conclusions TC,LDL-C,HDL-C,LVEF are the key predicators of Gensini scores in patients with coronary heart disease.LVEF and HDL-C are negatively correlated with Gensini scores,which can protect coronary arteries from atherosclerosis.LDL-C,TC and LDL-C/HDL-C ratio are positively correlated with Gensini scores,which are influencing factors for coronary artery atherosclerosis.