小而密低密度脂蛋白与冠心病及危险因素的关系——330例健康人与1000例冠脉造影结果分析  

Association of Small, dense Low-Density Lipoprotein With the risk of Coronary Heart Disease——Analysis of 330 controls and 1000 angiography results

作　　者：刘晓宁[1] 高岩[2] 张春玲[3] 孙静[4] 惠汝太 

机构地区：[1]中国医学科学院,北京100037 [2]中国协和医科大学,北京100037 [3]心血管病研究所,北京100037 [4]阜外心血管病医院,北京100037 [5]中-德分子医学研究室,北京100037

出　　处：《中国分子心脏病学杂志》2002年第3期31-34,共4页Molecular Cardiology of China

摘　　要：目的:观察冠心病(CHD)患者小而密低密度脂蛋白(sLDL)的水平,探讨sLDL与其它CHD危险因素的关系。方法:我们用2％～16％的非变性梯度胶电泳检测了经冠脉造影证实的818例CHD患者sLDL水平,用182例冠脉造影阴性者和330例性别、年龄匹配的健康人作为对照,观察各组间的变化及与预后的关系,同时对sLDL的影响因素采用多元逐步回归进行分析,以了解CHD危险因素对sLDL的影响。结果:(1)冠造阳性组的血浆sLDL(59.5±12.5)％明显高于冠造阴性组(52.0±12.2)％和对照组(45.1±10.O)％(P<0.01);心肌梗死组患者的血浆sLDL(60.3±12.3)％明显高于心绞痛组(58.4±12.7)％,(P<0.05)。(2)与冠造阴性组比较,sLDL异常者发生CHD的危险性是3.7倍,(95％的可信区间2.672-5.214,X^(2=)=64.3,P<<0.001);与正常对照组比较,心肌梗死的危险性是10.3倍(95％的可信区间7.480-14.40,X^(2=)=221.1,P<0.001)。(3)多元逐步回归分析显示:甘油三脂(TG)、肥胖、冠心病家族史、高密度脂蛋白胆固醇(HDL-c)与sLDL水平有关,(P<0.01),经校正影响因素后,sLDL仍然与冠心病密切相关(r=0.4017,P<0.001)。结论:sLDS水平与冠心病发生密切相关,并且与病情的严重程度有关,是冠心病重要的危险因素。objective The purpose of this study is to investigate the plasma levels of small LDL （sLDL）in patients with coronary heart disease （CHD）, and the relationship of sLDL with other risk factors of CHD. Methods We examined plasma levels of sLDL in 818 patients with CHD （documented by angiography）and CHD （-）182 men and 330 healthy volunteers by 2% - 16% undenatured gradient gel eleetrophoresis. Results （1）The plasma level of sLDL was higher in CHD group （59.5 ± 12.5）% than that in CHD （-）group （52.0 ± 12.2）% and normal controls （45.1 ± 10.0）% （P 〈 0.01）, and sLDL level in myocardial infarction （MI）group （60.3 ± 12.3）% was higher than that in angina pectoris （AP）group （58.4 ± 12.7）% （P 〈 0.05）. （2）. Compared with the CHD （-）group the calculation of odds ratios indicated relative risk estimates of 3.7 （95%CI 2.672 - 5.214 x^2 = 64.3,P 〈 0.001 ）for the CHD （ ± ）group , Compared with the controls, it was 10.3 （95%CI 7.480- 14.40,x^2 = 221.1 ,P 〈 0.001） for MI group. （3） Muhi-varietic regression analysis showed that there were close relationships between sLDL and triglyceride （TG）, Body mass index （BMI）, age, family history of CHD, high-density lipoprotein cholesterol （HDL-C）. there were closer relationships between sLDL and CHD （r= 0.4017, p 〈 0.001 ）by adjustment. Condusion Plasma sLDL were correlated with CHD and the severity of CHD . The sLDL abnormality is a important risk factors of CHD.

关 键 词：冠心病 小而密低密度脂蛋白 危险因素 

分 类 号：R541.4[医药卫生—心血管疾病]