急性冠状动脉综合征患者non-HDLC/HDLC比值与颈动脉斑块的关系  

Correlations Between non-HDLC/HDLC and Carotid Plaque with Acute Coronary Syndrome Patients

作　　者：温德惠[1] 张晓文[2] 董云云[3] 王义成[1] 郜新春[1] 李方江[4] 

机构地区：[1]河北北方学院附属第一医院超声科 [2]河北北方学院,河北省张家口市075000 [3]北京大学第一医院丰台医院,北京市100071 [4]河北北方学院附属第一医院心内科

出　　处：《中国动脉硬化杂志》2016年第5期503-506,共4页Chinese Journal of Arteriosclerosis

摘　　要：目的探讨急性冠状动脉综合征（ACS）患者non-HDLC/HDLC比值与颈动脉斑块之间的关系。方法选择95例ACS患者、30例稳定型心绞痛（SAP）患者及49例无冠心病者,按照颈动脉超声检查结果将颈动脉斑块分为软斑块、纤维斑块和钙化斑块三种类型。酶法测定血清低密度脂蛋白胆固醇（LDLC）、甘油三酯（TG）、总胆固醇（TC）、高密度脂蛋白胆固醇（HDLC）水平,并计算non-HDLC/HDLC比值。结果与无冠心病组和SAP组比较,ACS组non-HDLC/HDLC比值升高（P〈0.05或P〈0.01）;与无冠心病组比较,ACS组HDLC水平降低（P〈0.05）;与SAP组比较,ACS组non-HDLC水平升高（P〈0.05）。与无冠心病组比较,ACS组颈动脉斑块发生率升高（P〈0.001）;与无冠心病组和SAP组比较,ACS组软斑块发生率升高,纤维斑块发生率降低（P〈0.05或P〈0.01）。ACS患者钙化斑块组、纤维斑块组和软斑块组non-HDLC水平、non-HDLC/HDLC比值依次升高,且钙化斑块组与软斑块组间non-HDLC水平、non-HDLC/HDLC比较差异显著（P〈0.05或P〈0.01）。non-HDLC水平、non-HDLC/HDLC比值对ACS患者颈动脉软斑块诊断的ROC曲线下面积分别为0.722±0.060（95%CI为0.604~0.841,P〈0.01）、0.669±0.062（95%CI为0.548~0.790,P〈0.01）。结论 non-HDLC/HDLC比值升高是ACS患者发生软斑块的危险因素。non-HDLC/HDLC比值可作为ACS患者颈动脉软斑块的预测指标。Aim To investigate the correlations between carotid plaque types,non-HDLC/HDLC and non-HDLC in patients with acute coronary syndrome（ ACS）. Methods This study consists of 95 patients with ACS,30 patients with stable angina pectoris（ SAP）,and 49 healthy individuals who have no history of heart diseases serving as controls.All the selected cases underwent ultrasound examination of their carotid artery to diagnose carotid plaque types. The carotid plaques were classified into three types： soft plaque,fibrous plaque and calcified plaque. Their serum total cholesterol（ TC）,high density lipoprotein cholesterol（ HDLC）,triglyceride（ TG）,and low density lipoprotein cholesterol（ LDLC）levels were measured and recorded,and the non-HDLC / HDLC ratio was calculated. Results The results showed that,non-HDLC / HDLC ratio was higher in ACS patients（ P〈 0.05 or P〈 0.01） as compared to the SAP patients and the control subjects. The HDLC level was observed to be lower in ACS patients compared with the controls（ P〈 0.05）. An increased level of non-HDLC was seen in ACS patients compared to the SAP patients（ P〈 0. 05）. The prevalence of carotid plaque within the ACS patients was significantly higher than that of the control subjects（ P〈 0. 001）. The prevalence of soft plaque was significantly higher（ P〈 0.05） and the prevalence of fibrous plaque was significantly lower（ P〈 0.05 or P〈 0.01）in ACS patients than in SAP patients and control subjects. It was observed that the level of non-HDLC and non-HDLC /HDLC ratio were high in all the three types of carotid plaque,but the non-HDLC（ P〈 0.01） level and non-HDLC / HDLC ratio（ P〈 0.05） in the soft plaque group was significantly higher than in calcified plaque group. The receiver operating characteristics（ ROC） curve analysis was used to calculate the area under the curve（ AUC） for non-HDLC and nonHDLC / HDLC in ACS patients with soft plaque,which showed that AUC of non-HDLC was 0. 722 ± 0. 060（ 95% CI w

关 键 词：急性冠状动脉综合征 颈动脉斑块 non-HDLC/HDLC比值 

分 类 号：R5[医药卫生—内科学]