冠心病危险生物学标志物的探索  

Exploration of coronary heart disease risk biomarkers

作　　者：樊吉文 朱雅琪 张小飞 李军辉[3] 陈奕君 凌秋艳 梁如意 干伟[1] AN Jiwen;ZHU Yaqi;ZHANG Xiaofei;LI Junhui;CHEN Yijun;LING Qiuyan;LIANG Ruyi;GAN Wei(Department of Laboratory Medicine,West China Hospital of Sichuan University,Chengdu,Sichuan 610041,China;Medicine Laboratory Center of Northwest Women′s and Children′s Hospital,Xi′an,Shaanxi 710061,China;Department of Clinical Laboratory,the First People′s Hospital of Pingdingshan,Pingdingshan,Henan 467000,China)

机构地区：[1]四川大学华西医院实验医学科,四川成都610041 [2]西北妇女儿童医院医学检验中心,陕西西安710061 [3]河南省平顶山市第一人民医院检验科,河南平顶山467000

出　　处：《国际检验医学杂志》2020年第7期782-786,共5页International Journal of Laboratory Medicine

基　　金：四川省科技厅项目(2019YJ0061)。

摘　　要：目的对冠状动脉粥样硬化性心脏病(简称冠心病)的危险因素进行再评估,寻找更全面的冠心病预警指标。方法收集2018年8月至2019年12月四川大学华西医院经冠脉造影确诊为冠心病,且确认入院前未服用过他汀类等降脂药的298例患者作为冠心病组,收集无冠心病的健康人群290例作为对照组,分析两组患者病史和实验室指标的差异。结果冠心病组三酰甘油(TG)、非高密度脂蛋白胆固醇(Non-HDL-C)、残余胆固醇(RC)、单核细胞显著高于对照组,差异有统计学意义(P<0.05);冠心病组总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、载脂蛋白A(apoA)和同型半胱氨酸(Hcy)显著低于对照组,差异有统计学意义(P<0.05),多因素logistic回归分析提示TG、RC和Non-HDL-C升高是冠心病的独立危险因素,而apoA是冠心病的保护因素。结论临床在关注传统血脂四项的基础上,也应注意监测RC、Non-HDL-C、apoA水平。Objective To re-evaluate laboratory risk factors for coronary heart disease and to find more comprehensive early warning indicators of coronary heart disease.Methods From August 2018 to December 2019,298 patients who were diagnosed with coronary heart disease by coronary angiography at West China Hospital of Sichuan University and confirmed that they had never taken lipid-lowering drugs such as statins before admission were used as a case group.290 healthy people without coronary heart disease were collected as control group,which was used to analyze the differences in medical history and laboratory indicators between the two groups.Results The triglyceride(TG),non-high-density lipoprotein cholesterol(Non-HDL-C),remnant cholesterol(RC),and monocytes in the coronary heart disease group were significantly higher than those in the control group,the difference was statistically significant(P<0.05).Total cholesterol in the coronary heart disease group(TC),high-density lipoprotein cholesterol(HDL-C),apolipoprotein A(apoA),and homocysteine(Hcy)were significantly lower than those in the control group,the difference was statistically significant(P<0.05).Multivariate logistic regression analysis indicated that TG,Elevated RC and Non-HDL-C were independent risk factors for coronary heart disease,while apoA was a protective factor for coronary heart disease.Conclusion On the basis of paying attention to the four traditional blood lipids,we should also pay attention to monitoring the levels of RC,Non-HDL-C,and apoA.

关 键 词：冠心病 危险生物学标志物 非高密度脂蛋白胆固醇 残余胆固醇 

分 类 号：R541.4[医药卫生—心血管疾病]