阿托伐他汀对急性冠状动脉综合症患者血清sdLDL-C的影响  

The influence of atorvastatin treatment on serum sdLDL-C in acute coronary syndrome patients

作　　者：王连升[1] 庄兴[1] 张琦[1] 张正清[1] 范虞琪[2] 陈福祥[1] 

机构地区：[1]上海交通大学医学院附属第九人民医院检验科,上海200011 [2]上海交通大学医学院附属第九人民医院心内科,上海200011

出　　处：《检验医学》2011年第11期726-729,共4页Laboratory Medicine

基　　金：上海市卫生局青年基金(2010Y013)

摘　　要：目的探讨阿托伐他汀对急性冠状动脉综合症(ACS)患者治疗前、后血清小而密低密度脂蛋白胆固醇(sdLDL-C)水平的影响。方法选取初发ACS患者131例及同期中老年健康体检者178名,记录受试者一般情况,给予ACS患者口服阿托伐他汀(10 mg/d)调脂治疗,检测受试者治疗前、后血脂水平及血清sdLDL-C水平。统计分析受试者治疗前、后各指标的差异。结果健康对照人群血清sdLDL-C水平第95百分位数为0.62 mmol/L。调脂治疗后,ACS患者血清总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、非高密度脂蛋白胆固醇(non-HDL-C)、TC/HDL-C比值和sdLDL-C水平与治疗前比较差异有统计学意义(P<0.05)。治疗后sdLDL-C降低程度与治疗前血清TC、TG、LDL-C和non-HDL-C水平显著相关[相关系数(r)分别为0.329(P<0.001)、0.320(P<0.001)、0.232(P=0.013)、0.385(P<0.001)],与HDL-C水平和TC/HDL-C比值之间无相关性[r分别为-0.155(P=0.100)、0.046(P=0.624)]。LDL-C<2.59 mmol/L的ACS患者调脂治疗后血清sdLDL-C明显降低(P<0.05),sdLDL-C异常率由治疗前的26.9%下降到8.6%,二者比较差异有统计学意义(P<0.05)。结论常规阿托伐他汀调脂治疗可降低ACS患者血清sdLDL-C水平,亦可明显降低血脂水平正常的冠心病患者sdLDL-C异常率。Objective To investigate the influence of the atorvastatin treatment on serum small dense low-density lipoprotein cholesterol （sdLDL-C） in acute coronary syndrome （ACS） patients. Methods The 131 ACS patients and 178 healthy subjects were enrolled. The patients were treated with atorvastatin 10 mg/d. The blood lipid profile and serum sdLDLC-C were detected before and after the treatment. The differences were analyzed statistically before and after the treatment. Results The 95th percentile of sdLDL-C in healthy controls was 0. 62mmol/L. After the atorvastatin treatment, the levels of total cholesterol （TC） , triacylglycerol （TG） , high-density lipoprotein cholesterol （HDL-C）, low-density lipoprotein cholesterol （LDL-C）, non-HDL-C, TC/HDL-C ratio and sdLDL-C had statistical significance （ P 〈 0.05 ）. The reduction of sdLDL-C after the atorvastatin treatment was correlated with the levels of TC, TG, LDL-C and non-HDL-C before the treatment [ coefficient of correlation （r） ： 0. 329 （ P 〈 0. 001 ）, 0. 320 （ P 〈 0. 001 ）, 0. 232 （ P = 0. O13 ） and 0. 385 （ P 〈 0. 001 ） ]. There was no correlation between HDL-C level and TC/HDL-C ratio [r= -0.155 （P=0. 100） and 0.046 （P=0.624）1. In the ACS patients with LDL-C 〈2.59retooL/L, the treatment reduced the level of sdLDL-C with the sdLDL-C abnormality rate from 26.9% before the treatment to 8.6%. The difference had statistical significance （P 〈 0.05 ）. Conclusions The atorvastatin treatment can reduce the serum sdLDL-C in ACS patients, even can reduce the sdLDL-C abnormality rate in coronary artery disease patients with normal low blood lipid.

关 键 词：小而密低密度脂蛋白 急性冠状动脉综合症 危险因素 调脂治疗 

分 类 号：R446.1[医药卫生—诊断学]