急性冠脉综合征肥胖及非肥胖患者血清LDL-C/HDL-C比值与冠状动脉病变严重程度的相关性  

Correlation between LDL cholesterol/HDL cholesterol ratio and severity of coronary disease in obese and non-obese patients with acute coronary syndrome

作　　者：宋艳[1] 王亚萍[2] 索萌[2] 卢群[2] 田刚[2] 

机构地区：[1]西安交通大学医学院第一附属医院超声科,陕西西安710061 [2]西安交通大学医学院第一附属医院心血管内科,陕西西安710061

出　　处：《西安交通大学学报（医学版）》2013年第1期54-57,72,共5页Journal of Xi’an Jiaotong University（Medical Sciences）

基　　金：国家自然科学基金资助项目(No.30871042)~~

摘　　要：目的探讨急性冠脉综合征(ACS)肥胖及非肥胖患者血清低密度脂蛋白胆固醇(LDL-C)/高密度脂蛋白胆固醇(HDL-C)比值与冠状动脉病变严重程度的相关性。方法收集ACS患者394例,以BMI≥28.0kg/m2,或WHR男性>0.9,女性>0.85为肥胖标准,分为ACS肥胖组(n=78)和ACS非肥胖组(n=316),体检健康者作为对照组(n=101)。根据1984年美国心脏病协会规定的冠脉血管图像分段评价标准和Gensini积分系统对每支血管狭窄程度进行定量分析。比较ACS肥胖组和非肥胖组肥胖指标、血脂指标及Gensini积分水平变化,相关性分析肥胖组Gensini积分与各指标的相关性。结果 ACS肥胖患者LDL-C/HDL-C比值与Gensini积分正相关,ACS肥胖患者Gensini积分、TC、ApoB浓度在LDL-C/HDL-C高值亚组显著高于低值亚组(P<0.01),ApoA1在LDL-C/HDL-C高值亚组显著低于低值亚组(P<0.05)。Gensini积分在LDL-C/HDL-C低值亚组与高值亚组间比较有显著性差异(t=-3.511,P<0.05),而Gensini积分水平与LDL-C水平无明显相关性(t=-0.706,P>0.05)。结论 ACS肥胖患者血清LDL-C/HDL-C比值与冠脉病变程度密切相关,LDL-C/HDL-C比值较单纯LDL-C浓度能更好地反映冠脉病变的严重程度。Objective To investigate the correlation between low-density lipoprotein cholesterol （LDL-C）/ high-density lipoprotein cholesterol （HDL-C） ratio and severity of coronary disease in obese and non-obese patients with acute coronary syndrome （ACS）. Methods Totally 394 patients with ACS were divided into two groups., obesity with ACS [ n = 78, BMI≥28 kg/m^2 or WHR〉0.9 （male） or 〉0.85 （female）] and non-obesity with ACS （n 316）. Another 101 healthy individuals served as controls. According to results of coronary angiography, Gensini scores were calculated to quantize the severity of coronary arterial stenosis, and blood lipid indices were determined. Gensini scores and blood lipid indices were compared between the first two groups, and linear correlation analysis was made of Gensini scores and blood lipid indices. Results LDL-C/HDL-C ratio was positively correlated with Gensini scores in obese patients with ACS. Gensini scores, total cholesterol （TC） and ApoB were significantly higher in high LDL-C/HDL-C value sub-group than in low LDL-C/HDL-C value sub-group （P〈0.01） while ApoA1 was significantly lower in high LDL-C/HDL-C value sub-group than in low LDL-C/HDL-C value sub-group （P〈0.05）. There was a significant difference in Gensini scores between the low LDL-C/HDL-C value sub-group and the high-value sub-group （t =-3. 511, P〈0.05）. However, Gesini score was not significantly correlated with LDL-C in obese patients with ACS （ t =- 0. 706, P〉0.05）. Conclusion Gensini score in obese patients with ACS is significantly correlated with LDL-C/HDL-C ratio. LDL-C/HDL-C ratio may be a better index to estimate the severity of coronary lesion than LDL-C.

关 键 词：急性冠脉综合征 肥胖 GENSINI积分 低密度脂蛋白胆固醇 高密度脂蛋白胆固醇 冠脉损伤 

分 类 号：R692[医药卫生—泌尿科学]