小而密低密度脂蛋白胆固醇及其与低密度脂蛋白胆固醇之比、同型半胱氨酸对颈动脉粥样硬化的影响  

Association of small dense low-density lipoprotein cholesterols,sd LDL-C/LDL-C ratio and homocysteine with carotid atherosclerotic plaque

作　　者：程小兵[1,3] 罗娟娟 陈燕[1] 韩卫星[3] 单其俊[4] 杨玉雯[5] 潘文博 钟万生[1] 陈东 CHENG Xiaobing;LUO Juanjuan;CHEN Yan;HAN Weixing;SHAN Qijun;YANG Yuwen;PAN Wenbo;ZHONG Wansheng;CHEN Dong(Department of Cardiovascular Medicine,Hefei Third People's Hospital,Hefei 230000,China;不详)

机构地区：[1]合肥市第三人民医院心血管内科,合肥230000 [2]赣南医学院生理教研室,江西赣州342515 [3]安徽医科大学第一附属医院心血管内科,合肥230022 [4]江苏省人民医院心血管内科,南京201029 [5]皖南医学院第一附属医院心血管内科,安徽芜湖241001

出　　处：《实用医学杂志》2020年第19期2684-2689,共6页The Journal of Practical Medicine

基　　金：合肥市卫生计生委2016年应用医学研究重点课题(编号:Hwk2016zd009)。

摘　　要：目的评价小而密低密度脂蛋白胆固醇(sdLDL-C)及与低密度脂蛋白胆固醇之比(sdLDL-C/LDL-C)和同型半胱氨酸(Hcy)三者与颈动脉硬化的关系。方法随机选取我科在2017年10月至2019年10月的住院患者200例,根据颈动脉超声结果分为颈动脉内膜(IMT)异常组122例和对照组78例,其中颈动脉内膜异常组又分为颈动脉增厚组30例及颈动脉斑块组92例,Spearman直线相关分析颈动脉斑块与sdLDL-C的相关性,logistic回归模型评估颈动脉斑块的独立危险因素。结果颈动脉异常组sdLDL-C、sdLDL-C/LDL-C和Hcy明显高于对照组。logistic逐步回归分析显示,年龄、糖尿病、同型半胱氨酸、sdLDL-C/LDL-C、sdLDL-C是颈动脉增厚和颈动脉斑块的独立危险因素:年龄(95%CI:1.021~1.213,P<0.001)、糖尿病(95%CI:1.009~1.0394,P<0.001)、sdLDL-C/LDL-C(95%CI:1.012~1.449,P<0.001)、sdLDL-C(95%CI:0.876~0.934,P<0.001)、Hcy(95%CI:0.439~0.81,P<0.001)。结论sdLDL-C/LDL-C、sdLDL-C、Hcy具有颈动脉斑块的诊断价值,且是颈动脉粥样硬化的独立危险因素。Objective To evaluate the association of small and dense low-density lipoprotein cholesterol(sdLDL-C),its ratio to low-density lipoprotein cholesterol(sdLDL-C/LDL-C)and homocysteine(Hcy)with carotid atherosclerosis.Methods We randomly selected 200 cases of hospitalized patients from our department from October 2017 to October 2019 as research objects.According to the results of carotid artery ultrasound,patients were divided into carotid intima(IMT)abnormal group(n=122)and control group(n=78),and there were two subgroups in IMT abnormal group including carotid artery thickening group(n=30)and carotid artery plaque group(n=92).Spearman linear correlation analysis was used to analyze the correlation of carotid plaques with sdLDL-C and stepwise logistic regression model to assess the independent risk factors for carotid plaques.Results sdLDL-C,sdLDL-C/LDL-C and Hey in IMT abnormal group were significantly higher than those in the control group.Stepwise logistic regression analysis showed that age(95%CI:1.021~1.213,P<0.001),diabetes mellitus(95%CI:1.009~1.0394,P<0.001),Hey(95%CI:0.439~0.81,P<0.001),sdLDL-C/LDL-C(95%CI:1.012~1.449,P<0.001)and SDLDL-C(95%CI:1.012~1.449,P<0.001)were independent risk factors for carotid artery thickening and carotid artery plaque.Conclusion sdLDL-C/LDL-C,sdLDL-C and Hey have diagnostic value for carotid plaque and are independent risk factors for carotid atherosclerosis.

关 键 词：颈动脉斑块 颈动脉增厚 小而密低密度脂蛋白胆固醇 同型半胱氨酸 颈动脉粥样硬化 sdLDL-C/LDL-C 

分 类 号：R543.5[医药卫生—心血管疾病] R446.11[医药卫生—内科学]