非高密度脂蛋白胆固醇与冠状动脉病变的相关性研究

Study on the association between non-HDL-C and coronary artery lesions

目的探讨血清非高密度脂蛋白胆固醇(no-HDL-C)水平与冠状动脉病变的相关性,并比较它与低密度脂蛋胆固醇(LDL-C)与冠状动脉病变程度的差异。方法选取530例行选择性冠状动脉造影的患者,分别测定总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)和低密度脂蛋白胆固醇(LDL-C),并计算出non-HDL-C的含量(non-HDL-C=TC-HDL-C)。结果①冠脉造影阳性组血清non-HDL-C显著高于阴性组(P【0.01),并且随冠脉病变支数增多,血清non-HDL-C水平也增高。②Logistic回归结果显示在冠造阳性和阴性、1支病变与多支病变的比较中non-HDL-C的OR值分别是OR=1.032(95%CI1.011-1.049)和OR=1.007(95%CI1.002-1.012),略强于LDL-C;③冠状动脉病变支数、程度与脂质成份的逐步回归显示,non-HDL-C是年龄小于55岁的男性患者组中,最主要的变量。结论血清non-HDL-C是一项与冠状动脉病变相关的,且优于LDL-C的指标,特别在年龄小于55岁的男性患者中。这将对临床降non-HDL-C治疗时,选择合适人群提供有力的依据。

Objective To study the value of non-high-density lipoprotein cholesterol (non-HDL-C) in the assessment of severity of coronary artery lesions and to compare its predictive value with that of low-density lipoprotein cholesterol (LDL-C). Methods Total cholesterol (TC),triglyceride (TG),high-density lipoprotein cholesterol (HDL-C) were measured in 530 patients with selecting coronary angiograph. Then non-HDL-C were calculated with the formula: non-HDL-C=TC-HDL-C. Results 1. Serum non-HDL-C level in the positive angiograph group was significantly higher than that in the negative group (P<0.01)and increased with the number of affected vessels. 2. Logistic regression analysis showed that the OR values of non-HDL-C were 1.032 (95%CI 1.011-1.049) between the positive angiograph group and the negative group and 1.007 (95%CI 1.002-1.012) between one vessel lesion and multi-vessel lesions,and better than LDL-C. 3. The multivariant stepwise regression analysis of the vessel number,severity and lipids of coronary artery lesions showed that non-HDL-C was the best indicator in the male patients group who were under the age of 55 years.Conclusion Serum non-HDL-C level is related to the severity of coronary artery lesions which is superior to LDL-C,especially in men under the age of 55 years. This will benefit to lipid-lowering strategy in selecting proper individuals.