血脂及其比值与早发冠心病的相关性分析  

作　　者：代中礼[1] 汪芳松[1] 钱福东[1] 张朝君[1] 

机构地区：[1]安徽医科大学附属六安医院心血管内科二病区,安徽237000

出　　处：《当代医学》2016年第5期8-10,共3页Contemporary Medicine

摘　　要：目的探讨常规血脂水平及其比值与早发冠心病及病变程度的关系。方法研究选取282例因胸闷和（或）胸痛入院的疑似早发冠心病患者（男〈55岁,女〈65岁）,按照冠脉造影结果分为早发冠心病组170例和冠脉造影正常组112例,检测患者常规血脂指标及计算对应血脂比值TG/HDL、TC/HDL、LDL/HDL、apo B/apo A,比较2组间高血压、糖尿病、血脂水平及其相关比值等冠心病风险因素,同时观察血脂对早发冠心病病变程度的影响。结果研究结果发现早发冠心病患者男性比例高于正常组（χ-2=8.848,P=0.003）,同时血清apo B、TG及TG/HDL比值与正常对照组差异有统计学意义（apo B：=3.082,t P=0.002;TG：t=2.445,P=0.015;TG/HDL：t=7672.00,P=0.036）,其他血脂指标及比值均无统计学意义,逻辑回归分析发现apo B及男性与早发冠心病具有显著性相关（apo B：OR=5.90,95%CI 1.4-10.30,P=0.001;男性：OR=2.85,95%CI 1.52-5.31,P=0.001）,且早发冠心病两支病变患者Lp（a）和apo B/apo A比值明显关于单支病变（Lp（a）：t=3255.00,P〈0.0001;apo B/apo A：t=3637.50,P=0.031）。结论早发冠心病患者apo B、TG及TG/HDL比值显著性升高,同时apo B及男性是早发冠心病的独立风险因素,Lp（a）和apo B/apo A比值与早发冠心病病变程度存在一定的正相关性。Objective To investigate the level of serum lipid and lipid ratio and their relationship with severity of coronary artery lesions in patients with premature coronary heart disease. Methods Serum lipid level and lipid ratio （TG/HDL, TC/HDL, LDL/HDL, apoB/apoA） from 182 subjects （male〈55 years, female〈65 years） with the main complaint of chest pain, undergoing coronary artery angiography, including nomal coronary artery （control group） （n=l 12）, premature coronary heart disease group （pre-CHD group） （n=170） were measured by automatic biochemical analyzer and calculated. The risk factors of coronary heart disease in both groups and the significance of lipid on severity of coronary artery lesions in pre- CHD group were analysed. Results There were more male and higher apoB, TG and TG/HDL ratio in pre-CHD group compared with control group （male：z2=8.848, P=0.003; apoB： t=3.082, P=-0.002; TG; t=2.445, P=0.015; TG/HDL; t=7672.00, P=0.036）, but not other indicators, and logistic analysis showed that only apoB and male were significantly associates with premature coronary heart disease （apoB： OR=5.90, 95%CI 1.4-10.30, P=-0.001; male： OR=2.85, 95%CI 1.52-5.31, P=0.001）, meanwhile only Lp（a） and apoB/apoA ratio were significantly different between two-lesion and sigle-leision in pre-CHD group （Lp（a）： t=3255.00, P〈0.0001; apoB/apoA： t=3637.50, P=0.031）. Conclusion Serum apoB, TG and TG/HDL ratio were significantly higher in premature coronary artery disease, apoB and male were independent risk factors of premature coronary heart disease, and there may be a positive correlation for Lp（a） and apoB/apoA ratio with severity of coronary artery lesions.

关 键 词：早发冠心病 血脂比值 载脂蛋白B 

分 类 号：R541.4[医药卫生—心血管疾病]