Carotid atherosclerosis,coronary atherosclerosis and carotid intima-media thickness in patients with ischemic cerebral disease: Is there any link?

OBJECTIVES: The present study examined the association between carotid atherosclerosis, coronary atherosclerosis and common carotid artery intima-media thickness (CCA-IMT) in patients with incident ischemic stroke and its subtypes (75 cases and 21 controls). METHODS: Cases with ischemic brain infarctions (IBIs) were consecutively recruited and classified into subtypes by computed tomography and Bamford's classification (the size and site of the infarct) as one of the following: total anterior circulation infarcts (TACIs); partial anterior circulation infarcts (PACIs); posterior circulation infarcts (POCIs); and lacunar infarcts. Controls were recruited among individuals hospitalized for a reason other than cerebrovascular disease at the same institutions and matched for age and sex. Patients and controls underwent B-mode ultrasonographic measurements of CCA-IMT, and were evaluated by a qualified internist and neurologist for the presence of ischemic coronary disease and a history of previous stroke or transient ischemic attack. RESULTS: Of the 75 patients with an acute ischemic stroke, 10 (14%) were classified as TACIs, 34 (45%) as PACIs, 12 (16%) as POCIs and 19 (25%) as lacunar infarcts. Mean CCA-IMT was higher in patients (1.03+/-0.18 mm) than in controls (0.85+/-0.18 mm; P<0.0001). The history of cerebrovascular disease was much lower in the patients with POCI and TACI, and the prevalence of ischemic cardiac disease was in the range of 20% in patients with TACIs to more than 40% in patients with PACIs. CONCLUSIONS: An increased CCA-IMT as a marker of general atherosclerosis was associated with IBI and reflects cardiovascular risk. Carotid and coronary atherosclerosis were positively correlated with IBIs, with significant differences across the subtypes.     

外周动脉粥样硬化性狭窄与无症状冠状动脉狭窄相关

目的回顾性分析外周动脉粥样硬化性狭窄与无症状冠状动脉狭窄的关系,为临床实践提供线索。方法根据狭窄部位,将74例患者分为颈内动脉狭窄组(7例)、锁骨下动脉狭窄组(29例)、肾动脉狭窄组(15例)、髂股动脉狭窄组(15例)和多处狭窄组(8例),并观察:(1)单处外周动脉狭窄与无症状冠状动脉狭窄的关系,(2)多处外周动脉狭窄与无症状冠状动脉狭窄的关系,(3)外周动脉狭窄与冠心病高危因素的关系。结果单纯颈内动脉狭窄组(57.1%)、锁骨下动脉狭窄组(51.7%)、肾动脉狭窄组(80.0%)或髂股动脉狭窄组(53.3%)中均有半数以上的患者合并冠状动脉狭窄,其中肾动脉狭窄组更为明显(P<0.05)。多处狭窄组全部8例合并冠状动脉狭窄。结论外周动脉粥样硬化性狭窄但没有冠心病临床表现的患者,可能应当常规行选择性冠状动脉造影,评估是否合并存在冠状动脉疾病。     

稳定性冠心病患者循环内皮祖细胞与冠状动脉病变严重程度的分析

目的观察稳定性冠心病患者循环内皮祖细胞(EPCs)数量与冠状动脉病变严重程度的关系。方法对80例冠状动脉造影患者(排除急性冠状动脉综合征、心肌梗死)作病变严重程度及危险因素分析;以CD133/KDR作为EPCs标记物,用流式细胞仪检测患者的CD133/KDR双标记细胞数量。结果外周血EPCs数量与年龄、血清肌酐清除率(Ccr)、左室心肌重量指数(LVMI)呈负相关(P值分别=0.004,0.015,0.014);冠心病伴高血压患者较不伴高血压者EPCs数量显著减少(P=0.004)。冠状动脉造影阳性者EPCs数量较阴性者显著降低(P<0.01);EPCs数量与Gensini评分呈负相关(n=49,r=-0.305,P=0.039)。结论在稳定性冠心病患者循环EPCs数量与心血管危险因素及冠状动脉病变相关。     

The correlation of irregularities in carotid arterial intima-media thickness with coronary artery disease

Noninvasive ultrasonographic assessment of carotid artery intima-media thickness (IMT) can improve risk stratification for coronary artery disease (CAD) in certain patients. Several measurements have been used to evaluate carotid atherosclerosis by ultrasonography. Although it has been reported that angiographic arterial irregularities correlate with pathologic changes of atherosclerosis and the occurrence of cardiovascular events, only a few studies have assessed carotid arterial wall irregularity by ultrasonography. The purpose of this study was to evaluate the irregularity of IMT quantitatively, and its association with the presence or absence of CAD. The correlation of maximum and mean IMT values, and IMT irregularity with the presence or absence of CAD, was investigated in 90 patients who had undergone coronary angiography. IMT was measured by manual tracking of the far wall of the common carotid arteries, carotid bulbs, and internal carotid arteries. The IMT irregularity was defined as the root mean square (RMS) difference between each IMT and averaged IMT. Multiple logistic regression analysis, after adjustment for coronary risk factors, indicated that the RMS difference was a more accurate predictor of CAD than were the mean or maximum IMT values. These results indicate that the evaluation of IMT irregularity by ultrasonography is a useful predictor for the presence of coronary atherosclerosis. Received: March 13, 2002 / Accepted: June 15, 2002 Acknowledgment We are grateful to Hitachi Medical Corporation, Tokyo, Japan, for the computer software used for ultrasonographic measurement of intima-media thickness. Correspondence to T. Ishimitsu     

Unfavourable endothelial and inflammatory state in erectile dysfunction patients with or without coronary artery disease.

AIMS: Erectile dysfunction (ED) confers an independent cardiovascular risk. We investigated the role of low-grade inflammation and endothelial dysfunction in ED patients with or without coronary artery disease (CAD). METHODS AND RESULTS: We evaluated 141 men (age 58.8 years) for ED and CAD through a rigourous investigation (including coronary angiography to reveal occult CAD). Blood levels of inflammatory (hsCRP, IL-6, IL-1beta, and TNF-alpha) and endothelial-prothrombotic markers/mediators (vWF, tPA, PAI-1, and fibrinogen) were significantly increased in ED patients and correlated negatively with sexual performance. ED was associated with higher levels of these substances (except for IL-6) on top of CAD alone. For most substances, the unfavourable impact of ED alone was not significantly different than the impact of CAD alone. In multivariable models, these markers/mediators predicted independently ED presence. In our population, the negative predictive value of the combination of fibrinogen <225 mg/dL with IL-6 <1.24 pg/mL for excluding ED was 91.7% (95% CI: 61.5-99.8). CONCLUSION: ED is associated with increased inflammatory and endothelial-prothrombotic activation in men with or without CAD. ED confers an incremental unfavourable impact on the circulating levels of these markers/mediators when combined with CAD. These findings have implications for increased cardiovascular risk in ED patients.     

Endothelial functional and structural impairment in patients with different degrees of coronary artery disease development

Flow-mediated dilatation (FMD) and intima-media thickness (IMT) are noninvasive methods for patient evaluation. In this study we aimed to estimate the correlation between FMD and IMT in patients with different degree of coronary artery disease (CAD) development, and to explore their prognostic significance for the presence of angiographically significant coronary artery stenosis. We included 198 patients divided into five groups according to the degree of CAD development. All patients had FMD and IMT measured, 105 (53.03%) performed a Treadmill test in our clinic, and 146 (73.7%) underwent coronary arteriography (CAG). Patients with significant (> or = 50%) coronary artery stenosis had lower FMD and higher IMT values compared to patients without significant CAD: FMD: 2.78% +/- 2.71% vs 8.24% +/- 5.16%, respectively, P < 0.001; IMT: 0.882 +/- 0.17 mm vs 0.763 +/- 0.16 mm, respectively, P < 0.001. There existed a weak negative correlation between FMD and IMT (correlation coefficient: 0.242, P < 0.001), which was lost in subgroups and after controlling for the presence of significant CAD, number of diseased coronary arteries, and percent coronary artery stenosis. Analyzing the receiver operating characteristic curves we found that FMD values < or = 4.5% had 74% sensitivity, 77% specificity, positive predictive value (PPV) 81.8%, and negative predictive value (NPV) 68%, and IMT values > or = 0.81 mm had sensitivity 71%, specificity 67%, PPV 76.1%, and NPV 63.1% for the presence of significant CAD. Patients with advanced CAD had lower FMD and higher IMT values compared to patients with minor changes. The correlation between FMD and IMT was weak and inconsistent. Both methods demonstrated an acceptable prognostic significance for the presence of significant CAD.     

冠心病患者C反应蛋白变化的临床意义

目的　探讨 C反应蛋白 (CRP)与冠心病之间的关系。方法　冠心病组 (12 8例 )分为 3组 ,急性心肌梗死(AMI)组 34例 ,不稳定心绞痛 (U AP)组 49例 ,稳定性心绞痛 (SAP)组 45例。比较冠心病组各组间及与对照组(12 8例 )之间 CRP、白细胞 (WBC)、纤维蛋白原 (FIB)及血脂水平的差异。结果　冠心病组 CRP和 WBC水平高于对照组 (P分别为 0 .0 0 6和 0 .0 13) ,经调整性别、年龄、体重指数、吸烟史、高血压病及糖尿病史、血脂指标后 ,CRP和 WBC水平仍与冠心病患病率显著相关 ,OR(比数比 )分别为 1.6 83和 1.46 8(均 P<0 .0 5 )。 AMI组及 U AP组CRP水平与对照组相比有显著性差异 (P<0 .0 5 ,P<0 .0 0 1) ;UAP组与 SAP组相比 ,CRP水平也有显著性差异 (P<0 .0 5 ) ;而 SAP组与对照组相比 CRP水平则无明显差异 (P>0 .0 5 )。结论　 CRP是冠心病的独立危险因素。CRP升高提示冠心病患者病情不稳定     

早发冠心病的临床特点研究

目的 分析早发冠心病患者的传统危险因素、脂类代谢情况及冠状动脉病变特点.方法 收集临床资料和血管造影结果,对早发冠心病患者、非早发冠心病患者和非冠心病患者的传统危险因素、脂类代谢情况、冠状动脉病变特点进行统计学分析.结果 (1)早发冠心病与非早发冠心病比较,具有以下临床特点:①传统危险因素较少(2.50±1.28比2.76±1.43,P<0.05);②吸烟[50.3%(73/145)比38.0%(82/217),P<0.05]和阳性家族史[29.7%(43/145)比19.9%(43/217),P<0.05]比率较高,高血压比率较低[59.3%(86/145)比73.3%(159/217),P<0.05];③甘油三酯水平较高[(2.13±1.89)mmol/L比(1.78±1.14)mmol/L,P<0.05];④以急性冠状动脉综合征起病为主[66.2%(96/145)比42.6%(89/209),P<0.05],并且以单支血管受累为主[51.0%(74/145)比30.4%(66/217),P<0.05];⑤病例平均病变积分较低(4.86±2.30比5.92±2.66,P<0.05),轻度病变比率较高[46.9%(68/145)比31.2%(68/217),P<0.05].(2)logistic回归发现阳性家族史是早发冠心病发病的独立危险因素(OR=1.766,95%CI 1.060～2.940,P=0.029),吸烟(OR=1.561,95%CI 0.971～2.510,P=0.066)起较重要的作用.结论 与非早发冠心病相比,早发冠心病患者中传统危险因素虽所占比例较少,但冠心病阳性家族史和甘油三酯水平升高以及吸烟比例明显高于非早发冠心病患者,常以急性冠状动脉综合征起病为主,常为单支不稳定病变.提示冠心病阳性家族史即遗传倾向和代谢综合征在早发冠心病发生发展过程中起重要作用.     

原发性高血压患者颈动脉内膜-中层厚度与冠状动脉内皮功能的关系

目的:应用超声观察原发性高血压(EH)患者颈动脉内膜-中层厚度(IMT),并探讨其冠状动脉内皮功能及两者的相关性。方法:选择60例EH患者(EH组)、30例健康体检者(正常对照组),测定其颈动脉IMT及冷加压试验前后冠状动脉左主干内径变化百分率。结果:EH患者颈动脉IMT较正常对照组增厚,冷加压试验冠状动脉左主干内径变化百分率明显低于正常对照组。颈动脉IMT与冷加压试验冠状动脉左主干内径变化呈显著负相关。结论:EH患者存在明显的颈动脉IMT增加及冠状动脉内皮功能减低。     

女性冠心病患者临床表现特点分析

目的探讨冠状动脉粥样硬化性心脏病（冠心病,CHD）患者性别差异与临床表现的关系。方法将2007年1月至2008年12月住院并接受冠状动脉造影（CAG）的410例患者按性别分为两组,其中男性组267例、女性组143例,采用回顾性分析方法对两组病例临床资料、心电图和CAG结果进行对比。结果与男性患者相比,女性患病的年龄偏大,临床常伴发高血压、糖尿病和高脂血症,常有心悸、气短、恶心或呕吐和肩背放射性疼痛的伴发症状,临床表现和心电图对于确诊CHD的特异性低,冠状动脉造影多为单支病变,狭窄程度较轻。结论女性CHD患者发病年龄大、心绞痛不典型,伴随症状多,病变较轻,心电图对女性CHD患者的诊断有一定的局限性。     

冠心病合并外周动脉病变的治疗--附21例临床分析

目的　探讨冠心病患者合并外周血管病变的综合治疗方法。方法　对 2 1例合并外周血管病变的冠心病患者 ,采用经皮穿刺外周血管成形术治疗后进行心肌血运重建术或以便于内科药物治疗冠心病。结果　 2 1例外周血管成形术均获得成功 ,无严重并发症发生 ,使冠心病的进一步治疗获得良好的效果。结论　经皮穿刺外周血管成形术和支架植入术疗效好 ,成功率高 ,对冠心病的进一步治疗和预后有重要的意义     

冠心病患者心局部血管内皮生长因子的检测及临床意义

目的检测冠心病患者冠状静脉与主动脉血清中血管内皮生长因子(VEGF)的浓度差值,并探讨VEGF在冠心病发生、发展过程中的临床意义。方法冠心病组36例患者经选择性冠状动脉(冠脉)造影均被证实有明显的冠脉狭窄,对照组10例经临床检查和选择性冠脉造影排除冠心病。通过酶联免疫吸附法测定冠状静脉和主动脉血清中VEGF浓度,计算两个部位之间的差值,比较冠心病组[包括稳定型心绞痛(SAP)、急性冠脉综合征(ACS)]和对照组冠状静脉主动脉VEGF浓度差值间的差异。采集对照组循环外周血进行内皮祖细胞(EPCs)的分离培养,7d后搜集贴壁的梭形细胞,采用改良的Boyden小室检测VEGF对于EPCs迁移功能的影响。结果SAP组和ACS组患者冠状静脉主动脉VEGF浓度差值较对照组明显升高,SAP组与ACS组冠状静脉主动脉VEGF差异无统计学意义。VEGF明显改善EPCs的迁移功能。结论冠心病患者心局部血清VEGF水平升高,可能参与定向趋化EPCs至血管损伤及心肌缺血部位,继而在治疗性血管新生及内膜修复过程中发挥作用。     

冠心病患者冠状动脉病变进展的相关危险因素的探讨

目的:探讨影响冠状动脉粥样硬化性心脏病患者冠状动脉病变进展的危险因素。方法:选择138例在航空总医院心内科复查冠状动脉造影的冠心病患者,根据2次冠状动脉造影情况,分为冠状动脉进展组(86例)和无进展组(52例)。比较两组患者性别、年龄、吸烟史、高血压病史、糖尿病史、BMI、LDL、TG、TC、HDL-C以及两组糖尿病患者Hb A1c水平。采用多元Logistic回归分析各相关因素对冠状动脉病变进展的影响。结果:与无进展组相比,进展组男性比例更高(70%vs.42%,P<0.05),吸烟者比例更高(34.9%vs.11.5%,P<0.05),糖尿病患者比例更高(65%vs.31%,P<0.001)。糖尿病患者糖化血红蛋白比无进展组明显升高[(8.2±1.0)%vs.(6.4±0.8)%,P<0.05]。两组LDL平均值无差异,但无进展组LDL-C<1.4 mmol/L的比例明显高于进展组(23%vs.9%,P=0.03)。Logistic回归分析显示,男性(OR=4.800,95%CI:4.250~5.160,P=0.021)、吸烟(OR=3.966,95%CI:3.345~4.532 P=0.046)、糖尿病史(OR=4.048,95%CI:3.827~4.324,P=0.008)、Hb Alc(OR=59.44,95%CI:56.34~62.56,P<0.001)是冠心病患者冠状动脉病变进展的危险因素。结论:男性、吸烟、糖尿病、Hb A1c水平是冠心病患者冠状动脉病变进展最主要的危险因素,LDL促进冠状动脉病变进展。戒烟、控制Hb A1c水平以及控制LDL-c<1.4 mmol/L对延缓冠状动脉病变进展意义重大。     

Aortic velocity propagation: A novel echocardiographic method in predicting atherosclerotic coronary artery disease burden

BackgroundThe major burden of cardiovascular disease mortality around the globe is due to atherosclerosis and its complications. Hence its early detection and management with easily accessible and noninvasive methods are valuable. Aortic velocity propagation (AVP) through color M-mode of the proximal descending aorta determines aortic stiffness, reflecting atherosclerosis. The aim of this study was to find the utility of AVP in predicting coronary artery disease (CAD) burden assessed through SYNTAX (SYNergy between percutaneous coronary intervention with TAXus and cardiac surgery) score and compared with carotid intima-media thickness (CIMT), which is an established surrogate marker of atherosclerosis.MethodsIn this cross-sectional comparative study, we measured AVP by color M-mode and CIMT by using Philips QLAB-IMT software in 100 patients, who underwent conventional coronary angiogram (CAG) between May 2013 and November 2014. Coronary artery disease is considered significant if >50% diameter stenosis is present in any epicardial coronary artery and insignificant if otherwise.ResultsInitially, to know the normal range we measured AVP and CIMT in 50 patients without any major risk factors for CAD but CAG was not done. Aortic velocity propagation ranged from 46 cm/s to 76 cm/s (mean = 58.62 ± 6.46 cm/s), CIMT ranged from 0.50 mm to 0.64 mm (mean = 0.55 ± 0.03 mm). Among 100 patients who underwent CAG we found 69% had significant CAD, 13% had insignificant CAD, and 18% had normal coronaries. Those with significant CAD had significantly lower AVP (41.65 ± 4.94 cm/s) [F (2,97) = 44.05, p < 0.0001] and significantly higher CIMT (0.86 ± 0.11 mm) [F (2,97) =35.78, p < 0.0001]. AVP had significant strong negative correlation with CIMT (r = −0.836, p < 0.0001, n = 100) and SYNTAX score (r = –0.803, p < 0.0001, n = 69), while CIMT was positively correlated with SYNTAX score significantly (r = 0.828, p < 0.0001, n = 69).ConclusionsAVP and CIMT can predict CAD burden in a robust way. AVP may emerge as an exquisite bedside tool to predict atherosclerotic burden and guide in implementing preventive therapy for cardiovascular disease.     

Association of coronary artery disease, erectile dysfunction, and endothelial nitric oxide synthase polymorphisms

The purpose of this study was to determine the relationship between erectile dysfunction (ED), coronary artery disease (CAD), and T⁻⁷⁸⁶C and intron 4 a/b endothelial nitric oxide synthase (eNOS) polymorphisms in 419 patients with suspected or known CAD referred for coronary angiography. The patients had a high prevalence of risk factors for both CAD and ED: hypercholesterolemia (64%), hypertension (74%), diabetes mellitus (25%), obesity (30%), and smoking (63%). Three hundred and twenty-one patients had significant coronary atherosclerosis (luminal diameter narrowing of 50% or more of at least 1 coronary artery), 41 had insignificant coronary stenoses, and 57 patients were found to have coronary arteries without the evidence of atherosclerosis. The prevalence of ED in these groups was 79%, 76%, and 67% (P = NS), respectively. As compared to patients without ED, those with ED exhibited significantly higher probability of having significant coronary atherosclerosis (69% vs 79%, P = 0.04), higher number of significant coronary stenoses (median, 1 vs 2, P = 0.004), and a higher prevalence of a triple-vessel disease (12% vs 25%, P = 0.004). We did not find any relationship between T⁻⁷⁸⁶C and intron 4 a/b polymorphisms and the manifestation of coronary atherosclerosis or the presence of ED. In conclusion, in patients with numerous cardiovascular risk factors referred for coronary angiography, there was a high prevalence of ED in patients with both the presence and the absence of coronary atherosclerosis. The coincidence of CAD and ED identified patients at increased risk of severe forms of CAD.     

青年冠心病患者危险因素及冠状动脉病变的临床分析

目的探讨青年冠心病（CHD）患者危险因素及病变特点。方法选择冠状动脉造影确诊的青年CHD患者97例,男性94例,女性3例,回顾性分析危险因素、冠状动脉病变特点及支架置入资料。结果急诊住院42例（43．30％）,急性及陈旧性心肌梗死35例（36．08％）。各危险因素阳性率依次为：吸烟78．35％,高甘油三酯血症59．79％,严重超重53．61％,高血压43．30％,高胆固醇血症27．84％,家族史22．68％,酗酒18．56％,糖尿病12．37％;具有3个以上危险因素者51例（52．58％）。冠状动脉单支病变56例（57．73％）、双支病变27例（27．84％）、三支病变14例（14．43％）。病变血管狭窄〉75％者152支,左前降支（IAD）57．89％,回旋支（LCX）13．82％,右冠状动脉（RC）27．63％,左主干（LM）0．07％。支架置入术干预血管127支,支架的大小及长度为：LAD（3．25±0．34）mm×（23．47±4．36）mm,LCX（3．01±0．32）mm×（23．27±5．87）mm,RC（3．60±0．43）mm×（26．83±4．43）mm。结论多数青年CHD患者发病突然,病变严重,约半数患者病变累及LAD。吸烟、高甘油三酯血症、严重超重、高血压等是最重要的危险因素。     

冠心病合并肾动脉狭窄的发生率及危险因素

目的探讨冠心病合并肾动脉狭窄的发生率及危险因素。方法回顾性分析2003年5月至2004年8月期间造影证实冠心病同时行肾动脉造影患者的临床资料及影像学资料。结果350例冠心病中48例患者合并有肾动脉单侧或双侧显著性狭窄(直径狭窄≥50%),发生率为13.7%。多因素Logistic回归分析显示:年龄≥70岁、血肌酐≥120μmolL、高血压及冠状动脉多支病变是预测冠心病合并肾动脉狭窄的危险因素。结论冠心病患者合并肾动脉狭窄的发生率较高,对其行冠状动脉造影检查的同时应常规行肾动脉造影检查以检出合并的肾动脉狭窄。     

危险因素的评估在冠心病临床诊断中的参考价值研究

目的:探讨冠心病危险因素在诊断冠心病中的价值。方法:以选择性冠状动脉造影为金标准,对3355例临床诊断冠心病患者的主要冠心病危险因素(年龄、性别、糖尿病、高脂血症及高血压)和临床诊断符合率的关系进行分析。结果:3355例临床诊断冠心病的符合率为75.26%。无危险因素时冠心病临床诊断符合率仅为25%,有一个危险因素时为61.2%(P<0.001),冠心病危险因素越多,临床诊断符合率越高。患者年龄越大,符合率越高,误诊越少。男性、有糖尿病史、高脂血症患者符合率显著高于女性、无糖尿病、无高脂血症患者。尤其是≤50岁女性的临床诊断符合率仅为46.88%。高血压有无对诊断符合率无明显影响(P>0.05)。结论:冠心病整体危险因素评估对临床诊断冠心病有重要价值。应在了解冠心病整体危险因素基础上,评估临床表现和辅助检查结果,科学地作出冠心病诊断。     

颈动脉粥样硬化与冠心病关系的研究

目的:研究颈动脉粥样硬化与冠心病的关系。方法:对301例冠状动脉造影的患者作双侧颈动脉超声检查,根据冠脉造影结果分为正常组及冠心病组,冠心病组根据冠状动脉病变支数再分为一支病变组,二支病变组,三支病变组3个亚组。测量颈总动脉后壁内中膜厚度(IMT),斑块厚度,计算斑块积分及粥样斑块发生率。结果:(1)冠心病组IMT,斑块积分及斑块发生率明显高于正常对照组(P<0.01)。(2)随冠脉病变支数增加,斑块积分及IMT增加,亚组比较有显著性差异(P<0.01)。(3)以IMT>0.85mm和(或)出现粥样斑块预测冠心病,特异性75.3％,敏感性84.6％,阳性预测率88.4％。结论:通过颈动脉超声检查可为冠心病的诊断提供依据。     

血清甘油三酯代谢与冠状动脉病变的相关分析

目的 :分析冠心病 ( CHD)患者血清甘油三酯 ( TG)水平与冠状动脉病变的关系 ,探讨 TG在 CHD发生、发展中的作用。方法 :CHD患者 30 2例 ( CHD组 ) ,年龄 35～ 74岁 ,均经冠状动脉造影证实至少一支冠状动脉狭窄 >5 0 % ,其中单支病变 196例 ,双支病变 5 1例 ,3支病变 35例 ,左主干病变 2 0例。对照组 315例 ,年龄 2 6～ 6 4岁 ,为健康体检者。所有受检者检查前一天晚餐禁食高脂肪饮食及禁酒 ,次日晨 7:0 0～ 8:0 0采静脉血 2 ml测TG。以 TG>1.7m mol/ L为高 TG血症标准。结果 :CHD组、对照组血清 TG水平分别为 ( 1.7± 0 .6 ) mm ol/ L、( 1.4± 0 .5 ) mm ol/ L ,差异非常显著 ( P <0 .0 0 1) ;CHD组高 TG者比率为 33.4% ,对照组为 9.8% ,两者差异非常显著 ( P <0 .0 0 1)。 CHD组高 TG者双支、3支及左主干冠状动脉病变占 47.5 % ,正常 TG者为 2 8.9% ( P <0 .0 0 1) ,提示高 TG者冠状动脉病变相对较重。结论 :血清 TG水平与 CHD关系密切 ,对 CHD患者异常 TG的干预 ,应是 CHD防治策略的重要问题