成人低密度脂蛋白亚型与颈动脉内膜中膜厚度的关系  

Correlation between low density lipoprotein subfractions and carotid artery intima-media thickness in adults

作　　者：刘广彬 夏光伟 龚开政 张振刚 LIU Guangbin;XIA Guangwei;GONG Kaizheng;ZHANG Zhengang(Department of Cardiology,Affiliated Hospital of Yangzhou Univercity & the First People's Hospital of Yangzhou,Yangzhou,Jiangsu 225001,China)

机构地区：[1]扬州大学附属医院扬州市第一人民医院

出　　处：《中国动脉硬化杂志》2018年第11期1154-1158,共5页Chinese Journal of Arteriosclerosis

基　　金：中华医学会心血管分会领航基金项目(LHJJ20140321)

摘　　要：目的 评价Lipoprint法检测的低密度脂蛋白(LDL)亚型对颈动脉内膜中膜厚度(CA-IMT)的预测价值。方法 回顾性分析扬州大学附属医院心内科住院患者175例,平均年龄67岁,其中男性106例(60.6%),女性69例(39.4%)。所有患者应用Lipoprint脂蛋白分类检测系统对LDL细分类胆固醇及血脂四项定量分析,应用彩色多普勒超声检测仪测量颈总动脉内膜中膜厚度,分别比较传统危险因素下各分组间血脂水平及CA-IMT的差异。通过线性相关分析CA-IMT与传统危险因素及LDL各亚型的相关性,应用Logistic回归方法评估LDL亚型对CA-IMT的预测价值。结果 与男性比较,女性患者LDL4水平偏低(P<0.05),CA-IMT低于男性(P<0.01)。合并高血压及糖尿病等传统危险因素的患者小而密低密度脂蛋白(sdLDL)及其亚型、CA-IMT均高于正常对照组,但差异无统计学意义(P>0.05)。相关分析显示CA-IMT与性别呈负相关(P<0.05),与总胆固醇(TC)、LDL、非高密度脂蛋白(non-HDL)呈正相关(P<0.05);与sdLDL及LDL亚型LDL3、LDL4呈显著正相关(P<0.01)。CA-IMT还与传统危险因素吸烟呈正相关(P<0.05)。Logistic回归分析显示LDL、sdLDL以及sdLDL亚型LDL3、LDL4为CA-IMT增厚的独立预测因素。结论 sdLDL及其亚型与CA-IMT相关,对动脉粥样硬化有预测价值。Aim To evaluate the predictive value of low density lipoprotein subfractions detected by lipoprint method for carotid artery intima-media thickness (CA-IMT).Methods A retrospective analysis of 175 patients in the department of cardiology of our hospital, the average age was 67 years, including 106 males (60.6%) and 69 females (39.4%).In all patients lipoprint lipoprotein classification detection system was used for low density lipoprotein(LDL) subfractions of cholesterol and four types of blood lipids, the color Doppler ultrasound detector was used to measure the thickness of the carotid artery intima-media, the differences in blood lipid levels and CA-IMT between groups under traditional risk factors were compared.Linear correlation analysis was used to evaluate the relationship between CA-IMT and traditional risk factors and low-density lipoprotein subfractions.Logistic regression analysis was used to evaluate the predictive value of low-density lipoprotein subfractions in CA-IMT.Results Compared with males, the LDL4 level was lower in female patients (P<0.05), and the CA-IMT was lower than that in males (P<0.01).The small, dense low-density lipoprotein(sdLDL), subfractions and CA-IMT of patients with traditional risk factors such as hypertension and diabetes were higher than the normal group, but the difference was not statistically significant (P>0.05).Correlation analysis showed that CA-IMT was negatively correlated with gender (P<0.05), and positively correlated with total cholesterol (TC), LDL and non high density lipoprotein (non-HDL) (P<0.05); and it was positively correlatied with sdLDL, low-density lipoprotein subfractions LDL3, LDL4 (P<0.01).CA-IMT was also positively correlated with traditional risk factors smoking (P<0.05).Logistic regression analysis showed that LDL, sdLDL and sdLDL subfractions LDL3 and LDL4 were independent predictors of CA-IMT thickening.Conclusion Small, dense low-density lipoprotein and its subfractions have a correlation with CA-IMT and have predictive value for atheroscleros

关 键 词：低密度脂蛋白亚型 小而密低密度脂蛋白 颈动脉内膜中膜厚度 

分 类 号：R5[医药卫生—内科学]