血脂水平与冠心病关系的病例对照研究

目的　探讨血脂水平与冠心病发病的关系 .方法　选择住院确诊的冠心病患者 84例为病例组 ,排除冠心病的住院患者或健康体检者 16 3例为对照组 ,对两组的血脂水平、脂蛋白 (a)的均数进行比较 ,并用单因素和多因素分析计算危险因素的优势比 (OR)及 OR95 %可信限 (95 % CI) .结果　病例组的总胆固醇、三酰甘油、高密度脂蛋白水平分别为 4.13,1.79和 1.16 mm ol· L- 1 ,脂蛋白 (a)为 0 .38g· L- 1 ,而对照组血脂三项为 3.82 ,1.44和 1.34mmol· L- 1 ,脂蛋白 (a)为 0 .16 g·L- 1 ,两组间均有显著的统计学差异 (P<0 .0 5 ) ;单因素分析显示 :上述 4项指标的 OR值分别为 3.0 3,2 .42 ,3.76和 0 .2 1.多因素分析结果显示 :被筛选进入 L ogistic回归方程的变量分别为高密度脂蛋白、脂蛋白 (a)、胆固醇水平和每日吸烟量 .结论　吸烟和脂代谢紊乱是我国冠心病患者的主要危险因素 ,我国的胆固醇水平以国际统一标准作为正常值界限 ,标准过高 .这些线索将为我国冠心病危险因素的深入研究和冠心病防治策略的制定提供必要的参考依据 .

A case-control study on serum lipoproteins and coronary heart disease

AIM　To investigate the relationship between serum lipoprotein and coronary heart disease (CHD). METHODS　84 CHD inpatients were selected as c ase group and 163 non-CHD persons from inpatients or healthy population were defined as control group. Se rum total cholesterol (TC), triglyceride (TG), high density lipoprotein (HDL-c) and Lipop rotein (a) (Lp (a)) were measured. RESULTS　Means of TC, TG, HDL-c and Lp (a) in ca s es were 4.13 mmol*L-1, 1.79 mmol*L-1, 1.16 mmol*L-1 and 0.3 8 g*L-1 respectively, while means of those variable in controls were 3.82 mmol*L-1, 1.44 mmol*L-1, 1.34 mmol*L-1 a nd 0.16 g*L-1. Differences between two groups were significan (P<0.05). Uni-variable analysis indic ated that elevation of TG, TC and Lp (a) and decrease of HDL-c were significan tly related to risk of CHD with Odds Ratio (OR) of 3.03, 2.42, 3.76 and 0.21 respectively. Multi-variable analy sis showed that HDL-c, TC, Lp (a) and consumption of cigarettes per-day were the variables bei ng selected in Logistic equation. CONCLUSION　Dislipidemia and cigarette smokin g might be the major risk factors of coronary heart disease in China and in terms of TC disputed boundary, the international standard is too high for Chinese.