LDL-C/HDL-C与冠状动脉病变程度的相关性研究  

Relationship between LDL-C/HDL-C and severity of coronary artery disease

作　　者：李明春[1] 初少莉[1] 左君丽[1] 曾一梅[2] 

机构地区：[1]上海交通大学医学院附属瑞金医院北院高血压科,上海201801 [2]上海交通大学医学院附属瑞金医院北院输血科,上海201801

出　　处：《第二军医大学学报》2014年第3期270-273,共4页Academic Journal of Second Military Medical University

摘　　要：目的探讨血脂与冠状动脉病变程度的相关性。方法选择2005至2011年共4 751例经冠状动脉造影的住院患者,根据冠脉造影结果分为2组,冠脉狭窄≥50%为冠心病组(n=3 402),冠脉狭窄<50%为对照组(n=1 349)。冠心病组根据病变血管支数分为1支病变、2支病变、3支及3支以上病变3个亚组。测定患者的血清总胆固醇(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),计算LDL-C/HDL-C比值。比较上述指标在各组间的差异,并采用Spearman相关分析研究LDL-C/HDL-C比值与冠状动脉病变程度之间的关系,用多元逐步logistic回归分析确定冠心病的危险因素。结果与对照组比较,冠心病组TG、TC、LDL-C水平及LDL-C/HDL-C比值升高,HDL-C水平降低,差异均有统计学意义(P<0.01);在冠心病组中,随着冠状动脉病变支数的增加,LDL-C/HDL-C比值逐渐升高(P<0.001),冠状动脉病变支数与LDL-C/HDL-C比值呈正相关(R=0.25,P<0.01);多元logistic回归分析显示高LDL-C/HDL-C比值为冠心病的独立危险因素。结论 LDL-C/HDL-C比值是冠心病的独立危险因素,且与冠状动脉病变程度呈正相关。Objective To explore the relationship between blood lipids and the severity of coronary artery disease. Methods A total of 4 751patients with chest pain were divided into two groups according to the results of coronary angiography:coronary artery disease group(n=3 402stenosis in one main branch stenosis≥50%)and control group(stenosis<50%,n=1 349).According to the number of coronary artery stenosis,the coronary artery disease group was divided into three subgroups(group 1:1branch stenosis;group 2:2branch stenosis;and group 3:3or more than 3branch stenosis).The serum total cholesterol(TC),triglycefides(TG),high density lipoprotein cholesterol(HDL-C),and low-density lipoprotein cholesterol(LDL-C)were determined and LDL-C/HDL-C was calculated.The relationship between lipids and the severity of coronary artery stenosis was analyzed by Spearman correlation analysis,and the risk factors of coronary artery disease were analyzed by multiple-stepwise logistic regression analysis.Results The levels of TG,TC,LDL-C and the ratio of LDL-C/HDL-C in the coronary artery disease group were significantly lower than those in the control group(P<0.01).LDLC/HDL-C ratio increased with the increase of diseased branches in the disease group(P<0.001),and the number of diseased branches was positively correlated with the ratio of LDL-C/HDL-C(R=0.25,P<0.01).Logistic multiple regression analysis showed that high LDL-C/HDL-C level was an independent risk factor for coronary heart disease.Conclusion LDL-C/HDL-C ratio is an independent risk factor for coronary heart disease and it is positively correlated with the severity of coronary artery lesions.

关 键 词：LDL胆固醇 HDL胆固醇 脂类 冠心病 

分 类 号：R541.4[医药卫生—心血管疾病]