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1.
卢群  田刚  张勇  鲁敏  马爱群 《心脏杂志》2017,29(4):411-415
目的 探讨中国汉族人群高密度脂蛋白胆固醇(HDL-C)与冠心病的关系。 方法 收集2008年8月~2009年8月入住西安交通大学医学院第一附属医院心内科冠心病患者375例,和健康对照者348例,清晨抽取空腹静脉血,检测总胆固醇(TC)、三酰甘油(TG)、HDL-C、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白(Apo)A-I和ApoB,并计算TG/HDL-C、TC/HDL-C、LDL-C/HDL-C和ApoB/ApoA-I比值。通过logistic回归分析和ROC曲线分析各血脂指标与冠心病的关系和诊断价值。 结果 与对照组相比,冠心病组患者TG、TG/HDL-C、TC/HDL-C、LDL-C/HDL-C、ApoB/ApoA-I水平显著增高,而HDL-C、ApoA-I较对照组显著降低。在校正年龄、性别、吸烟史、高血压病史和糖尿病史后,经多变量logistic回归分析,发现TG、HDL-C、TG/HDL-C、TC/HDL-C、LDL-C/HDL-C和ApoB/ApoA-I进入回归模型,回归系数分别为:0.222、-1.878、0.258、0.248、0.657和1.566,经ROC曲线分析发现,上述各指标的曲线下面积分别为0.612(P<0.01)、0.717(P<0.01)、0.680(P<0.01)、0.653(P<0.01)、0.661(P<0.01)、0.616(P<0.01),提示HDL-C水平降低对冠心病的诊断价值最大。 结论 HDL-C水平与中国汉族人群冠心病有相关性。  相似文献   

2.
目的:通过分析中原地区冠心病患者血脂谱特征,探讨载脂蛋白B/载脂蛋白AI(ApoB/ApoAI)比值作为冠心病危险因素评估指标的必要性和优势.方法:冠状动脉造影确诊的正常对照组和冠心病患者,进行血脂及载脂蛋白生化分析,统计各血脂谱的相关性,比较各相关系数的差异.结果:①TC、LDL-C、non-HDL-C、ApoB、TC/HDL-C和ApoB/ApoAI各指标在冠心病组显著高于对照组(P<0.05).②冠心病组HDL-C浓度在各水平分层的比例均明显低于对照组(P=0.002),而TC和LDL-C差异无统计学意义(P>0.05).③LDL-C与non-HDL-C有最密切的相关性(r=0.959),两者与ApoB/ApoAI的相关性差异无统计学意义(P>0.05),而两者分别与ApoB/ApoAI的相关性与ApoB/ApoAI和ApoB、TC/HDL-C的相关性有显著差异(P<0.05).结论:中原地区冠心病患者具有低HDL-C的特征,由于各血脂谱统计学相关性的显著差异,ApoB/ApoAI比值可能是反映此类患者心血管病风险的理想标志物和治疗靶点.  相似文献   

3.
目的 分析探讨血脂及部分血脂比值对冠心病的诊断价值.方法 对210例患者行冠状动脉造影,根据造影结果分为对照组(冠状动脉无狭窄者)和冠心病组,冠心病组再根据Gensini评分分为轻度、中度和重度组,测定血脂水平并对其单项血脂和部分血脂比值与冠脉狭窄程度进行比较分析.结果 冠心病组的总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白B(ApoB)高于正常对照组,载脂蛋白A1(ApoA1)和高密度脂蛋白胆固醇(HDL-C)低于正常对照组(P均<0.05).冠心病组的TC/HDL-C、TG/HDL-C、LDL-C/HDL-C高于正常对照组,ApoA 1/ApoB低于正常对照组(P均<0.05).随着冠脉病变程度增加,TG/HDL-C、TC/HDL-C、LDL-C/HDL-C值升高,ApoA1/ApoB值降低(P<0.05).结论 血脂和血脂比值异常对冠心病的诊断及其严重程度的判断上具有一定意义,血脂比值较单项血脂有更好的临床价值.  相似文献   

4.
目的探讨血清中血脂、脂蛋白及载脂蛋白(Apo)与老年动脉粥样硬化及冠心病的相关性。方法采用贝克曼DXC-600全自动生化分析仪,对60例老年冠心病和60例健康人血脂及Apo进行检测。结果冠心病组三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白B(ApoB)与对照组比较,差异有统计学意义(P<0.05);高密度脂蛋白胆固醇(HDL-C)、载脂蛋白A1(ApoA1)水平低于对照组,差异有统计学意义(P<0.05);两组总胆固醇(TC)比较,差异无统计学意义(P>0.05)。冠心病组LDL-C/HDL-C、ApoA1/ApoB、LDL-C/ApoB、HDL-C/ApoA1比值与对照组比较,差异有统计学意义(P<0.05)。结论 HDL-C、LDL-C、ApoB及HDL-C/TC、ApoA1/ApoB比值的异常统称为老年动脉粥样硬化及冠心病的危险因子,可以作为临床诊断老年动脉粥样硬化及冠心病的重要参考指标之一。  相似文献   

5.
本文报道207例健康老年人和71例冠心病老年人血清载脂蛋白及脂蛋白组分含量的变化。结果显示冠心病患者的TC、TG、LDL-C、ApoB.、LDL-C/HDL、ApoA-I/HDL-C显著高于健康老年人。单因素相关分析显示冠心病的HDL-C与LDL-C、TG呈明显的负相关,而与HDL-PL是正相关。高胆固醇血症的冠心病患者HDL-C、ApoA-I显著低于健康老年人,而TG相反。  相似文献   

6.
目的探讨老年冠心病合并2型糖尿病病人血脂比值与冠状动脉病变严重程度的相关性。方法选取2016年6月—2017年12月于山西医科大学第一医院住院且行冠状动脉造影检查确诊为冠心病的老年2型糖尿病病人204例,根据Gennisi积分(GS)分为低分组(72例)、中分组(81例)、高分组(51例),比较3组病人的临床特征,分析血脂比值与GS积分的相关性。结果总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、非高密度脂蛋白胆固醇(non-HDL-C)、空腹血糖、糖化血红蛋白(HbA1c)、TC/高密度脂蛋白胆固醇(HDL-C)、LDL-C/HDL-C、non-HDL-C/载脂蛋白A1(ApoA1)、LDL-C/ApoA1、载脂蛋白B(ApoB)/ApoA1水平均与GS评分呈正相关,ApoA1水平与GS评分呈负相关。在控制影响因素空腹血糖和HbA1c后,这些血脂比值仍与GS评分存在较强相关性(r值分别为0.266、0.273、0.290、0.265、0.232,P0.05)。结论除常规血脂指标外,TC/HDL-C、LDL-C/HDL-C、non-HDL-C/ApoA1、LDL-C/ApoA1、ApoB/ApoA1等血脂比值对老年2型糖尿病病人发生冠心病的风险具有更高的预测价值。  相似文献   

7.
目的观察重叠综合征(OS)患者血脂及脂蛋白代谢的变化特点及其可能机制。方法健康对照组40例及OS组140例均测定血清总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)及载脂蛋白(Apo)A1、B水平,同时计算ApoB/ApoA1比值,分析OS患者血脂及脂蛋白代谢的变化特点;根据呼吸暂停低通气指数(AHI)及末梢血氧饱和度情况,将OS组分为轻、中度、重度OS组,比较上述指标情况,探讨AHI及末梢血氧饱和度与TC、TG、HDL-C、LDL-C及ApoB/ApoA1的相关性。结果与对照组相比,OS组TC、TG、LDL-C、ApoB及ApoB/ApoA1比值水平明显升高,HDL-C、ApoA1明显降低(P<0.05);与轻度OS组相比,中、重度OS组TC、TG、LDL-C、ApoB及ApoB/ApoA1比值水平显著升高,HDL-C、ApoA1明显降低(P<0.05),其中,重度OS组改变更为明显(P<0.05);TC、TG、LDL-C、ApoB及ApoB/ApoA1与AHI呈正相关,与末梢血氧饱和度呈负相关;HDL-C、ApoA1与AHI呈负相关,与末梢血氧饱和度呈正相关(P<0.05)。结论OS患者存在脂质代谢异常,其血脂代谢异常的严重程度和低氧相关。  相似文献   

8.
目的:探讨冠心病合并代谢综合征(MS)患者血脂特点及MS对冠脉病变程度的影响。方法:冠状动脉造影确诊为冠心病的患者258例,分为MS以及非MS组,计算其gensini评分并测定血清脂质谱以及其他相关危险因素,评价冠心病合并MS患者血脂特点及其与冠脉病变严重程度的关系。结果:冠心病合并MS组与不合并MS组患者比较,冠脉病变的程度和范围均明显加重(P〈0.01).MS组血浆甘油三酯(TG)、总胆固醇(TC)、载脂蛋白B(ApoB)以及ApoB/A1比值较未合并MS组的明显增高(P〈0.05~〈0.01).高密度脂蛋白-胆固醇(HDL-C)显著低于对照组(P〈0.01),而ApoA1以及低密度脂蛋白-胆固醇(LDL-C)并无显著差异,操作特征曲线(ROC)的曲线下面积(AUC)最大者为TG(0.732),其次为ApoB、LDL-C/HDL-C、HDL-C以及ApoB/ApoA1。结论:冠心病合并MS患者存在多种脂质参数异常,与冠状动脉损伤范围以及狭窄密切相关.TG、TC、HDL-C以及ApoB是评价MS较好的脂质参数。  相似文献   

9.
目的探讨老年冠心病(CHD)患者冠状动脉粥样硬化严重程度有效评估的血脂指标。方法选取2012年2月至2013年2月由于疑似CHD在该院心内科住院接受冠状动脉照影的患者152例,依据冠状动脉照影结果分为CHD组、非CHD组,CHD组患者进一步依据冠脉病变程度和冠脉病变血管数进行分组,对比各患者各项血脂指标。结果按冠脉病变程度分组研究显示,非CHD组与轻度病变组之间各项血脂指标均无统计学差异(P>0.05);CHD组内高密度脂蛋白胆固醇(HDL-C)随着冠脉病变程度的增加而降低,其余指标均升高;相关性分析显示,病变程度与低密度脂蛋白(LDL-C)/HDL-C、血浆促动脉硬化指数(AIP)之间呈正相关(P<0.05);同HDL-C之间呈负相关(P<0.01)。按冠脉病变血管数分组研究显示,HDL随着病变血管范围扩大而下降,多支病变组低于单支组和非CHD组,两支病变组低于单支组和非CHD组(P<0.05);病变血管范围与LDL-C/HDL-C、AIP、载脂蛋白(Apo)A/ApoB之间呈正相关(P<0.05);同HDL-C之间呈负相关(P<0.01)。结论高水平HDL-C在预防老年CHD的发生、发展有着十分重要的意义;ApoA/ApoB水平可能是评估冠状脉粥样硬化程度的一个重要指标,AIP和LDL-C/HDL-C值可更加准确地显示老年CHD患者脂类代谢水平。  相似文献   

10.
目的观察脑心通胶囊对冠心病合并脂蛋白异常血症病人血脂及内皮素(ET)的影响。方法将90例冠心病合并脂蛋白异常血症病人随机分为治疗组(45例)与对照组(45例),两组基础治疗相同,治疗组加服脑心通胶囊,治疗4周后,观察两组病人血脂、内皮素及临床症状等变化。结果与对照组比较,治疗组在降低总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、内皮素、载脂蛋白B(ApoB)、脂蛋白(a)[LP(a)]和升高载脂蛋白A、ApoA及其与ApoB比值方面疗效更为显著(P〈0.05),两组升高高密度脂蛋白胆固醇(HDL-C)的疗效相似。结论脑心通胶囊可有效调节冠心病合并脂蛋白异常血症病人血脂水平,改善血管内皮功能,降低内皮素。  相似文献   

11.
目的 检测老年冠心病患者的颈动脉硬度,探讨其与冠心病的相关性及在老年冠心病诊断中的价值.方法 选择35例老年冠心病患者进行冠状动脉(冠脉)造影,并根据其结果进行冠脉病变评分,同时检测颈动脉硬度;并与高血压组、高血脂组和健康老年组比较.结果 老年冠心病组的颈动脉紧张度(8.15±1.54)、动脉扩张性(0.34±0.07)及动脉僵硬度(640.51±150.98)与其他组比较,差异有统计学意义(P<0.05或P<0.01),且与冠脉病变积分呈明显相关(P<0.05或P<0.01).结论 老年冠心病患者的颈动脉硬度指标变化程度与冠脉狭窄程度相平行,可以作为预测冠心病的发生、发展及严重程度的一个指标.  相似文献   

12.
BACKGROUND: Complement factor H (CFH) is a plasma protein that is essential in the regulation of the alternative complement pathway and has been implicated as taking part in complement inhibition in atherogenesis. We evaluated the association of the Y402H polymorphism with incident coronary heart disease (CHD), incident ischemic stroke, and carotid artery wall thickness (intima-media thickness (IMT)) in the Atherosclerosis Risk in Communities (ARIC) cohort. METHODS: Incident ischemic stroke and CHD were identified through annual telephone calls and hospital and death certificate surveillance. Carotid IMT was measured by means of high-resolution B-mode ultrasound. Four hundred eighty-three validated ischemic stroke and 1,544 CHD events were identified. Because of allele frequency differences between whites and African Americans, analyses were performed separately according to the racial group. RESULTS: The 402HH homozygous genotype was a significant predictor of incident ischemic stroke in whites (hazard rate ratio (HRR) 1.47, 95% confidence interval (CI) 1.05-2.05). Significant interaction effects between genotype and hypertension were observed for CHD in whites and for cIMT in whites and African Americans. In further analyses of incident CHD, genotypes carrying the 402H allele were a significant predictor of incident CHD in whites who had hypertension (402YH: HRR 1.19, 95% CI 1.01-1.40; 402HH: HRR 1.28, 95% CI 1.04-1.57). The 402H allele was also associated with higher cIMT measures for whites in the overall cohort, and for whites with hypertension. CONCLUSION :The CFH 402H allele was associated with an increased risk for incident CHD and ischemic stroke in whites, with the strength and significance of the association dependent upon hypertension status.  相似文献   

13.
The aim of this investigation was to analyze metabolic syndrome (MS) impact on carotid intima‐media thickness (cIMT). Prospective study of 300 patients with suspected coronary artery disease admitted for an elective coronary angiography were evaluated. Patients with previously known cardiac disease were excluded. In the population, 23.0% were diabetics and 40.5% had MS (but no diabetes). cIMT was not significantly different in patients with MS, but was significantly higher in diabetic patients compared with MS and control patients. Independent predictors of cIMT were age, male gender, insulin, and high‐density lipoprotein (HDL) cholesterol (the last one with an inverse association). In patients without MS, only age and HDL cholesterol were associated. In patients with MS, independent predictors were age, male gender, and glucose, and abdominal obesity showed an inverse relationship. In patients with stable angina, MS is not an independent predictor of cIMT. Nonmodifiable variables (age and gender) are the most important determinants of cIMT, as well as blood glucose, in MS patients. Abdominal obesity was protective. J Clin Hypertens (Greenwich). 2012;00:00–00. ©2012 Wiley Periodicals, Inc.  相似文献   

14.
慢性阻塞性肺疾病对冠心病患者外周血管病变的影响   总被引:1,自引:0,他引:1  
目的观察冠心病(CHD)合并慢性阻塞性肺疾病(COPD)患者的外周血管病变情况,并探讨其机制。方法对CHD合并COPD患者(86例)和单纯CHD患者(76例)行肾动脉造影、踝臂指数(ABI)、血管内皮舒张功能、颈动脉粥样硬化积分及血气分析、血脂、肾功能检查。结果 CHD合并COPD组较CHD组ABI〈0.9和肾动脉狭窄的患者比例升高(74.4%vs39.5%,P〈0.01;24.4%vs11.8%,P〈0.05),动脉血氧分压下降[(75±8)vs(88±8)mmHg,P〈0.01],肱动脉内皮舒张功能明显减弱[(0.7±3.4)%vs(7.0±1.9)%,P〈0,01],CHD合并COPD组血清肌酐较CHD组明显升高[(112±43)vs(91±27)μmol/L,P〈0.01]。结论 COPD加速了下肢动脉粥样硬化和肾动脉粥样硬化,并导致肾功能不全加重。其机制与内皮舒张功能不全有关。  相似文献   

15.
冠心病患者颈动脉超声检查的特征   总被引:1,自引:1,他引:0  
目的:观察冠心病患者的颈动脉超声检查的特征,探索冠心病病情严重程度与颈动脉超声检查的关系。方法:选择在心内科同期住院的102例冠心病患者,其中心肌梗死(MI)患者37例,非MI患者65例,另选58例非冠心病患者作为正常对照组。测定颈动脉超声图像,血流动力学指标,血脂、血糖等生化指标,并进行统计学分析。结果:颈动脉超声显示,颈动脉内膜中层厚度在冠心病非MI组[(0.99±0.18)mm],MI组[(0.99±0.22)mm]明显大于正常对照组[(0.78±0.11)mm],P〈0.05,颈总动脉最大流速冠心病非MI组[(71.34±19.76)cm/s],MI组[(78.92±20.61)cm/s]明显高于正常对照组[(67.38±14.35)cm/s],P〈0.05。冠心病非MI组斑块发生率为69.2%,MI组为62.2%,明显高于正常对照组(36.2%,P均〈0.01)。Pearson相关分析显示颈动脉内膜中层厚度与总胆固醇、低密度脂蛋白-胆固醇、甘油三酯水平呈显著正相关(标准化回归系数0.460~0.862,P均〈0.001)。结论:颈动脉超声不仅可间接评价冠心病患者,且颈动脉内膜中层的厚度与血脂异常显著相关。  相似文献   

16.
Eklund C  Friberg P  Gan LM 《Atherosclerosis》2012,221(1):118-123
ObjectiveThe radial artery wall structure can be measured with non-invasive very high-resolution ultrasound with great feasibility and high accuracy. In the present study, we aim to explore clinical correlates of radial artery intima-media thickness (rIMT), in a relatively large patient cohort with suspected coronary artery disease, and further compare those to common carotid artery IMT (cIMT) that is an accepted surrogate marker of atherosclerosis.MethodsFour hundred and sixteen patients referred to myocardial perfusion scintigram (MPS) were recruited, and cIMT and rIMT were scanned using conventional and very high-resolution ultrasound (55 MHz transducer), respectively. A number of plasma biomarkers were also measured.ResultsBoth cIMT and rIMT were similarly correlated with disease history, MPS-verified ischemia, carotid plaque burden, and lipid status. Repeated measurement of rIMT showed acceptable variability.ConclusionRadial artery IMT may constitute a novel feasible imaging biomarker for systemic atherosclerosis burden, which may be used in future imaging trials to evaluate, e.g. anti-atherosclerotic treatments.  相似文献   

17.
Kawasaki disease (KD) is an acute medium vessel vasculitis seen in children. The most significant long-term complication is related to coronary artery abnormalities. Use of intravenous immunoglobulins, however, has led to significant reduction in incidence of coronary aneurysms. What is more alarming is the fact that higher risk of cardiovascular disease is seen in even those children who do not have coronary artery aneurysms during subacute phase. Various factors like abnormal lipid profiles, abnormal vessel wall reactivity and endothelial dysfunction have been implicated for this. Carotid intima-media thickness (cIMT) has been used as a surrogate marker for atherosclerosis. This study was planned to evaluate cIMT in children with KD. Twenty-seven children with diagnosis of KD at least 1 year prior to enrolment were evaluated for cIMT at enrolment and then after 3 months. Fasting lipid profile was done for all patients. Mean cIMT was significantly higher in children with KD compared to controls. In lipid profiles, undesirable HDL-C and triglyceride levels were seen in 2 and 3 children, respectively. Undesirable and borderline LDL-C levels were seen in 1 and 2 patients, respectively. Undesirable and borderline total cholesterol levels were seen in 1 and 3 patients, respectively. Higher cIMTs were seen in our cohort of KD patients. Proatherogenic abnormalities in lipid profile were seen in a few patients. Both abnormalities may predict a higher risk of atherosclerosis in future. The results of this study need to be replicated on a larger study sample and over longer follow-up periods.  相似文献   

18.
Objectives: Bilirubin has been demonstrated to be linked with anti-inflammatory and antioxidant progress. We aimed to evaluate the association between serum total bilirubin level and carotid intima-media thick-ness (cIMT) in patients with prehypertension. Methods: We consecutively enrolled pre-hypertensive patients from a community in Guangzhou between January 2017 and January 2018. All patients underwent carotid artery ultrasonography measurement. The correlation between serum total bilirubin and cIMT was assessed by using the Pearson’s correlation coefficient. Multiple logistic regression analysis was performed to assess the independent association between clinical parameters and carotid atherosclerosis. Results: A total of 691 subjects with prehypertension were included in this study. There were 101 patients with increased cIMT (mean age 52.69 ± 11.58 years; 50 male) and 590 subjects with normal cIMT (mean age50.28 ± 10.33 years; 332 male). We found that cIMT was significantly related with systolic blood pressure(r = 0.257, P < 0.001), C-reactive protein (r = 0.327, P < 0.001), total cholesterol (r = 0.218, P = 0.002) and total bilirubin (r =?0.489, P < 0.001). A multiple logistic regression analysis revealed that total bilirubin was an independent factor for atherosclerosis (OR = 0.476; 95%CI: 0.253, 0.764; P < 0.001). Conclusion: Our results suggested that serum total bilirubin was inversely related with cIMT, and might be an early clinical marker for predicting the occurrence of subclinical carotid atherosclerosis in patients with prehypertension.  相似文献   

19.
Background: Framingham risk scores (FRS) were validated in a mostly Caucasian population. Evaluation of subclinical atherosclerosis by carotid ultrasound may improve ascertainment of risk in nonwhite populations. This study aimed to evaluate carotid intima‐media thickness (cIMT) and carotid plaquing among Mexican Americans, and to correlate these markers with coronary risk factors and the FRS. Methods/Results: Participants (n = 141) were drawn from the Cameron County Hispanic Cohort. Carotid artery ultrasound was performed and cIMT measured. Carotid plaque was defined as areas of thickening >50% of the thickness of the surrounding walls. Mean age was 53.1 ± 11.7 years (73.8% female). Most were overweight or obese (88.7%) and more than half (53.2%) had the metabolic syndrome. One third (34.8%) had abnormal carotid ultrasound findings (either cIMT ≥75th percentile for gender and age or presence of plaque). Among those with abnormal carotid ultrasound, the majority were classified as being at low 10‐year risk for cardiovascular events. Carotid ultrasound reclassified nearly a third of the cohort as being at high risk. This discordance between 10‐year FRS and carotid ultrasound was noted whether risk was assessed for hard coronary events or global risk. Concordance between FRS and carotid ultrasound findings was best when long‐term (30‐year) risk was assessed and no subject with an abnormal carotid ultrasound was categorized as low risk by the 30‐year FRS algorithm. Conclusions: Integration of carotid ultrasound findings to coronary risk assessments and use of longer term prediction models may provide better risk assessment in this minority population, with earlier initiation of appropriate therapies.  相似文献   

20.
颈动脉粥样硬化对冠心病的预测价值   总被引:2,自引:1,他引:1  
目的:研究超声检测颈动脉粥样硬化对冠心病的预测价值。方法:应用彩色多普勒超声仪观察230例冠心病患者与41例非冠心病患者颈动脉内膜-中膜厚度(IMT)、斑块形成情况和斑块积分。结果:颈动脉IMT与斑块发生率和斑块积分在冠心病组明显高于对照组(P〈0.05)。结论:超声检查颈动脉硬化可在一定程度上反映冠状动脉粥样硬化情况,可帮助评估预后。  相似文献   

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