不同类型冠心病患者高密度脂蛋白的测定  

Determining Serum High Density Lipoprotein Cholesterol Levels in Patients of Various Types of Coronary Heart Disease

作　　者：秦光明[1] 夏舜英[1] 

机构地区：[1]浙江医科大学附属二院心脑血管病研究室,杭州市310009

出　　处：《中国动脉硬化杂志》1999年第3期248-250,共3页Chinese Journal of Arteriosclerosis

摘　　要：为了探讨冠心病患者血清高密度脂蛋白值下降的临床意义，对冠心病患者（ 急性心肌梗死患者、不稳定型心绞痛患者和稳定型心绞痛患者） 分别进行胆固醇、甘油三酯、高密度脂蛋白胆固醇及低密度脂蛋白胆固醇值测定，并与健康者作对照。结果显示，冠心病患者血清胆固醇值与对照组无显著性差异（ Ｐ＞ ０ ．０５） ，而血清高密度脂蛋白胆固醇值却明显低于健康对照组（ Ｐ＜ ０ ．０１） ；在冠心病组中，男性患者血清高密度脂蛋白胆固醇值的下降较女性患者更为明显（ Ｐ＜ ０ ．０１） 。急性心肌梗死患者血清高密度脂蛋白胆固醇值明显低于不稳定型心绞痛患者组及稳定型心绞痛患者组（ Ｐ＜ ０ ．０１） ；当血清胆固醇值≤５ ．１６ ｍｍｏｌ／ Ｌ时，不但急性心肌梗死患者组血清高密度脂蛋白胆固醇值明显低于不稳定型心绞痛患者组及稳定型心绞痛患者组（ Ｐ＜ ０ ．０１） ，而且不稳定型心绞痛患者组血清高密度脂蛋白胆固醇值也明显低于稳定型心绞痛患者组（ Ｐ＜ ０ ．０１ ） ；当血清胆固醇值≤５ ．１６ ｍ ｍｏｌ／ Ｌ和甘油三酯≤２ ．８１ ｍ ｍｏｌ／ Ｌ时，高密度脂蛋白胆固醇值≤０ ．９０ ｍｍｏｌ／ Ｌ者在急性心肌梗死患者组中最多见。Aim To study the clinical significance of low serum high density lipoprotein cholesterol (HDLC) levels in patients with coronary heart disease(CHD). Methods 224 patient with CHD were divided into acute myocardial infarction (AMI,n=90), unstable angina pectoris (UAP,n=78), stable angina pectoris (SAP,n=56) groups. Serum total cholesterol, triglyceride, HDLC levels were examined in 224 patients with CHD and in 50 healthy controls. Results There was no significant difference in serum total cholesterol levels between the CHD patient group (4.72±1.05 mmol/L) and healthy control group(4.78±0.72 mmol/L)(P>0.05), while serum HDLC level was significantly lower in CHD patient group (1.14±0.30 mmol/L) than healthy control group (1.45±0.26 mmol/L)(P<0.01). Serum HDLC level was significantly lower in AMI group than in UAP and SAP groups (P<0.01), when serum total cholesterol level was ≤ 5.16 mmol/L, serum HDLC levels were significantly lower not only in AMI group than in UAP and SAP groups (P<0.01), but also in UAP group than in SAP group (P<0.05). In CHD patients ,serum HDLC level was lower in smoking group (n=71) than in non-smoking group(n=57)(P<0.01). Conclusions Decrease of serum HDLC level is the most important lipid risk factor of CHD, especially in CHD patients with average or low average total serum cholesterol levels, and relates to the different CHD patterns.

关 键 词：冠心病 心肌梗死 不稳定型心绞痛 高密度脂蛋白 

分 类 号：R541.4[医药卫生—心血管疾病] R542.22[医药卫生—内科学]