血清氧化低密度脂蛋白与不同年龄男性冠心病患者的相关性  

Correlation of oxidized low-density lipoprotein with coronary artery disease in male patients among different age

作　　者：胡允兆[1] 黄裕立[1] 陈玉映[1] 吴焱贤[1] 黎文生[1] 杨友[1] 陈盈文[1] 

机构地区：[1]南方医科大学附属顺德第一人民医院心内科,广东佛山528300

出　　处：《岭南心血管病杂志》2013年第2期146-150,共5页South China Journal of Cardiovascular Diseases

基　　金：广东省医学科研基金(项目编号:B2011310;A2012663);广东省科技计划项目(项目编号:2009B3060700010);广东省佛山市科技发展专项(项目编号:2009025;2011AA100473);佛山市科技计划项目(项目编号:201208210)

摘　　要：目的探讨血清氧化低密度脂蛋白(oxidized low-density lipoprotein,Ox-LDL)与不同年龄阶段男性冠状动脉粥样硬化性心脏病(冠心病)患者的相关性。方法入选男性冠心病患者153例,对照组患者149例,各再分别按照年龄分为3个亚组:A组≤55岁;B组56～70岁;C组≥71岁。采集各组传统冠心病危险因素,包括原发性高血压(高血压)、血糖、血脂、肥胖、吸烟及超敏C反应蛋白等;利用弗明翰危险评分(FRS)计算患者10年冠心病发生风险;采用双抗体夹心酶联免疫吸附试验法测定血清Ox-LDL浓度;分析不同年龄阶段冠心病患者的危险因素差异及与Ox-LDL的相关性。结果在A组中,吸烟、高三酰甘油血症、Ox-LDL、超敏C反应蛋白是冠心病的独立危险因素(P<0.01)。在B组、C组中,吸烟、高血压、糖尿病、总胆固醇、低密度脂蛋白、Ox-LDL、超敏C反应蛋白是冠心病的独立危险因素(P<0.05)。在不用年龄阶段患者中,校正了年龄、血脂异常、吸烟、高血压、糖尿病、超敏C反应蛋白等因素后,Ox-LDL均为冠心病的独立危险因素,但在A组患者中相关性更为明显[A组:OR=3.68,95%CI(1.70～9.61);B组:OR=2.01,95%CI(1.14～3.54);C组OR=1.56,95%CI(1.13～2.15)]。冠心病组A组和对照组A组的弗明翰危险评分估算风险比较,差异无统计学意义[5.9%±1.0%vs.4.8%±0.8%,P>0.05]。结论不同年龄阶段男性冠心病患者的危险因素存在一定差别。Ox-LDL是冠心病的独立危险因素,但在中青年男性患者中其相关性更为明显,提示体内氧化应激与男性早发冠心病的危险密切相关。Objectives To investigate the correlation of oxidized low-density lipoprotein （Ox-LDL） with coronary artery disease （CAD） in male patients among different age. Methods Totally 153 consecutive angiographically proven CAD male patients were enrolled, and 149 age-matched non-CAD individuals （coronary angiographic normal or negative findings by coronary uhrafast computerized tomography） were set as control group. All the patients were grouped into 3 subgroups according the age ： subgroup A ： age ≤ 55 ; subgroup B ： age 56-70, subgroup C ： age ≥ 71. Conventional risk factors [hypertension, dyslipidemia, diabetes mellitus, obesity, smoking, high-sensitivity C-reactive protein （hs- CRP） ] were evaluated in CAD group and control group. Framingham risk score and absolute 10-year CAD events risk were calculated for each individual. Ox-LDL was measured by competitive enzyme linked immunosorbent assay. Relationship of Ox-LDL and CAD in different age groups was analyzed. Results In subgroup A, smoking, triglyceride, Ox-LDL and hs-CRP were independently correlated with CAD （P〈0.01）. While in subgroup B and subgroup C, smoking, hypertension, diabetes mellitus, total cholesterol, low-density lipoprotein cholesterol （LDL-C）, Ox-LDL and hs-CRP were independently correlated with CAD （P〈0.05）. Ox-LDL were independently correlated with CAD in all age groups after adjusted for age, dyslipidemia, smoking, hypertension, diabetes mellitus and hs-CRP. However, it is most obvious in subgroup A [subgroup A： 0R=3.68, 95% CI （1.70-9.61）; subgroup B： OR=2.01, 95% CI （1.14-3.54） ; subgroup C： 0R=1.56, 95% CI （1.13-2.15）]. Framingham risk score in subgroup A of CAD group had no significant difference with that in subgroup A of control group [5.9%±1.0% vs. 4.8%±0.8%, P〉0.05]. Conclusions Risk factors in male patients with CAD in different age groups are different. Ox-LDL is an important independent risk factor for CAD, while it is most obvious in young and middle age group. Oxidati

关 键 词：冠状动脉疾病 氧化低密度脂蛋白 中青年 男性 

分 类 号：R543.4[医药卫生—心血管疾病]