稳定型冠心病患者未干预血脂谱的横断面研究  

Lipid Profile in Non-treated Patients with Stable Coronary Artery Disease: A Crosssectional Study

作　　者：高莹 李莎 叶平[2] 陈红[3] 李艳芳[4] 华琦[5] 张燕 徐瑞霞 郭远林 李建军 

机构地区：[1]中国医学科学院阜外医院血脂中心,北京市100037 [2]中国人民解放军301医院心内科,北京市100853 [3]北京大学人民医院心内科,北京市100044 [4]北京安贞医院心内科,北京市100029 [5]北京宣武医院心内科,北京市100053

出　　处：《中国动脉硬化杂志》2016年第5期510-516,共7页Chinese Journal of Arteriosclerosis

基　　金：国家自然科学基金(81070171;81241121);高等学校博士学科点专项科研基金(20111106110013);首都临床特色应用研究基金(Z121107001012015);首都医学发展科研基金(2011400302);北京市自然科学基金(7131014)

摘　　要：目的评价冠心病患者未干预情况下的血脂谱,探讨冠心病的预测因素。方法入选1772例临床怀疑冠心病并且未服用调脂药的患者进行冠状动脉造影检查,其中1057例被诊断为冠心病,715例无冠心病。分析并比较两组患者的血脂谱。分析血脂水平和冠心病的相关性。结果冠心病患者的血脂谱如下：甘油三酯1.78mmol/L（1.29~2.43 mmol/L）、总胆固醇（TC）4.92±0.99 mmol/L、高密度脂蛋白胆固醇（HDLC）1.09±0.29 mmol/L、低密度脂蛋白胆固醇（LDLC）3.22±0.91 mmol/L。冠心病患者中LDLC和非HDLC都能达标者（LDLC〈1.81 mmol/L＋非HDLC〈2.59 mmol/L）仅占2.46%。在50~59岁、60~69岁、≥70岁亚组中,男性患者TC、HDLC、载脂蛋白A1（Apo A1）和Apo B水平显著低于女性（均P〈0.05）。Apo B/Apo A1是冠心病的最强预测因子。结论未服用调脂药的冠心病患者中血脂水平升高,其中大部分都存在轻度或中度血脂异常,血脂达标率很低,而且女性血脂异常程度更严重。非HDLC、Apo B、LDLC/HDLC和Apo B/Apo A1与冠心病相关性好,可以预测冠心病风险。Aim To evaluate the lipid profile in non-treated patients with coronary artery disease（ CAD）; To explore the prediction factors of CAD. Methods 1772 patients with clinically suspected CAD and without use of lipidregulating drugs were enrolled,and undergone by coronary angiography. 1057 cases were diagnosed as CAD,and 715 cases were without CAD. Blood lipid profiles of the two groups were analyzed and compared. Correlation between blood lipid levels and CAD was analyzed. Results The blood lipid profiles in patients with CAD were as follows： triglyceride 1.78 mmol / L（ 1. 29- 2. 43 mmol / L）,total cholesterol（ TC） 4. 92 ± 0. 99 mmol / L,high density lipoprotein cholesterol（ HDLC） 1.09±0.29 mmol/L,low density lipoprotein cholesterol（ LDLC） 3.22±0.91 mmol/L. LDLC and non-HDLC were able to meet the standards（ LDLC1.81 mmol / L and non-HDLC2.59 mmol / L） in only 2.46% patients with CAD.In 50-59 years,60-69 years,≥70 years subgroups,the levels of TC,HDLC,apolipoprotein A1（ Apo A1） and Apo B in male patients were significantly lower than that in female patients（ all P〈 0. 05）. Apo B / Apo A1 was the strongest predictor of CAD. Conclusion Blood lipids levels are increased in CAD patients without use of lipid-regulating drugs,most of which are mild or moderate dyslipidemia,and standard-reaching rate of blood lipids is low. The degree of abnormal blood lipids is more serious in women. Correlation between non-HDLC,Apo B,LDLC / HDLC,Apo B / Apo A1 and CAD is good,which can predict the risk of CAD.

关 键 词：血脂谱 未干预 冠心病 相关性 预测 

分 类 号：R18[医药卫生—流行病学]