高血压前期患者残余胆固醇与冠状动脉狭窄严重程度的相关性  

Correlation between remnant cholesterol and severity of coronary artery stenosis in patients with prehypertension

作　　者：陈焱 赵昕[2] 艾冠男 高嘉良 王兆丰 杨晓旭[3] 顾崇怀 徐兆龙 CHEN Yan;ZHAO Xin;AI Guannan;GAO Jialiang;WANG Zhaofeng;YANG Xiaoxu;GU Chonghuai;XU Zhaolong(Department of Cardiovascular Medicine,the First Affiliated Hospital of Jinzhou Medical University,Jinzhou,Liaoning 121001,China;Department of Cardiovascular Medicine,the Second Affiliated Hospital of Dalian Medical University,Dalian,Liaoning 116027,China;Department of Cardiovascular Medicine,the Second Affiliated Hospital of Shenyang Medical College,Shenyang,Liaoning 110016,China;Jinzhou Medical University Graduate Educational Base of Dongfeng General Hospital of Sinopharm,Shiyan,Hubei 442000,China;Department of Cardiovascular Medicine of Gen-eral Hospital of Northern Theater Command,Shenyang,Liaoning 110016,China;Department of Cardiovascular Medicine of Anqing Hospital of Anhui Medical University,Anqing,Anhui 246000,China)

机构地区：[1]锦州医科大学附属第一医院心血管内科,辽宁省锦州市121001 [2]大连医科大学附属第二医院心血管内科,辽宁省大连市116027 [3]沈阳医学院附属第二医院心血管内科,辽宁省沈阳市110016 [4]锦州医科大学国药东风总医院研究生培养基地,湖北省十堰市442000 [5]北部战区总医院心血管内科,辽宁省沈阳市110016 [6]安徽医科大学附属安庆医院心血管内科,安徽省安庆市246000

出　　处：《中国动脉硬化杂志》2021年第12期1047-1052,共6页Chinese Journal of Arteriosclerosis

基　　金：科技部国家重点研发计划项目(2020YFC2004701)。

摘　　要：目的基于Gensini评分探究高血压前期患者残余胆固醇与冠状动脉狭窄严重程度的相关性。方法回顾性分析2004—2014年北部战区总医院心血管内科住院的36216例冠状动脉造影患者的临床资料,共有421例高血压前期患者。其中Gensini评分≥20的患者有85例,同时选取该队列中Gensini评分<20的患者85例作为对照组。观察两组患者的临床特点并探究残余胆固醇及常见血脂指标在高血压前期患者中与冠状动脉狭窄程度的关系。美国预防、检测、评估与治疗高血压全国联合委员会第七次报告将高血压前期定义为收缩压120~139 mmHg(1 mmHg=0.133 kPa)和(或)舒张压80~89 mmHg。欧洲动脉粥样硬化协会(EAS)将残余胆固醇定义为总胆固醇-(高密度脂蛋白胆固醇+低密度脂蛋白胆固醇)。残余胆固醇为富含甘油三酯脂蛋白中的胆固醇含量。结果在Gensini评分≥20组中,糖尿病患者比例、左心室射血分数均高于Gensini评分<20组,差异具有统计学意义(P<0.05)。在血脂相关的指标中,Gensini评分≥20组患者的残余胆固醇、甘油三酯及总胆固醇水平均高于Gensini评分<20组,差异具有统计学意义(P<0.05)。在Gensini评分≥20组中对残余胆固醇及甘油三酯进行相关性分析,结果显示残余胆固醇与甘油三酯存在相关性(r=0.535,P<0.01)。随后继续筛选出甘油三酯≥1.7 mmol/L的患者并进一步进行相关性分析,结果显示残余胆固醇与甘油三酯的相关性进一步增加(r=0.625,P<0.01)。多因素Logistic回归分析显示,在高血压前期患者中残余胆固醇(OR=8.90,95%CI为2.87~27.53,P<0.01)、低密度脂蛋白胆固醇(OR=3.56,95%CI为1.93~6.57,P<0.01)及糖尿病(OR=2.34,95%CI为1.10~5.00,P<0.05)与严重冠状动脉狭窄显著相关。结论残余胆固醇、低密度脂蛋白胆固醇、糖尿病等因素与高血压前期合并冠心病患者发生严重冠状动脉狭窄密切相关。Aim To explore the correlation between remnant cholesterol and severity of coronary artery stenosis in patients with prehypertension based on Gensini score.Methods The clinical data of 36216 coronary angiography patients hospitalized in the Department of Cardiovascular Medicine of Northern Theater Command General Hospital from 2004 to 2014 were retrospectively analyzed,including 421 patients with prehypertension.There were 85 patients with Gensini score≥20,and 85 patients with Gensini score<20 in this cohort were selected as the control group.The clinical characteristics of the two groups were observed and the relationship between remnant cholesterol and common blood lipid indexes and the degree of coronary artery stenosis in prehypertensive patients was investigated.The seventh report of the National Joint Committee on the prevention,detection,evaluation,and treatment of hypertension in the United States defines prehypertension as systolic blood pressure of 120 to 139 mmHg(1 mmHg=0.133 kPa)and/or diastolic blood pressure of 80 to 89 mmHg.The European Atherosclerosis Society(EAS)defines remnant cholesterol as total cholesterol-(high density lipoprotein cholesterol+low density lipoprotein cholesterol).Remnant cholesterol is the amount of cholesterol in triglyceride-rich lipoprotein.Results In the Gensini score≥20 group,the proportion of diabetic patients and left ventricular ejection fraction were higher than those in the Gensini score<20 group,the difference was statistically significant(P<0.05).In terms of lipid-related indicators,the levels of remnant cholesterol,triglyceride and total cholesterol in Gensini score≥20 group were higher than those in the Gensini score<20 group,the differences were statistically significant(P<0.05).The correlation analysis of remnant cholesterol and triglyceride in Gensini score≥20 group was conducted.The results showed that there was a correlation between remnant cholesterol and triglyceride(r=0.535,P<0.01).Subsequently,patients with triglyceride≥1.7 mmol/L were screene

关 键 词：残余胆固醇 高血压前期 冠状动脉狭窄 GENSINI评分 横断面研究 

分 类 号：R5[医药卫生—内科学]