高血压对男性冠心病患者血脂和载脂蛋白的影响

 目的观察高血压对男性冠心病患者血脂和载脂蛋白的影响.方法将276例患者分为高血压病组(EH,83例)、冠心病组(CHD,85例)、高血压合并冠心病组(EH+CHD,108例).选择健康体检者106例作为对照组.比较三组患者的血脂和载脂蛋白的变化情况,并做分层分析.结果(1)三组患者的总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白B(Apo B)水平均明显高于对照组,而高密度脂蛋白胆固醇(HDL-C)、载脂蛋白A-I(Apo AI)和Apo AI/B的水平明显降低(P＜0.05).(2)未按年龄分组时,各项血脂水平在三组患者中差异无统计学意义.(3)按年龄分层后,≤55岁组中EH+CHD组TC、甘油三酯(TG)和LDL-C的水平最高.结论高血压患者存在血脂代谢紊乱,在合并冠心病时高血压对血脂具有叠加作用,应加强中青年男性高血压患者的调脂治疗.

Influence of hypertension on plasma lipids and apolipoproteins in male patients with coronary heart disease

Objective To investigate the effects of hypertension on plasma lipids and apolipoproteins in male patients with coronary heart disease.Methods 276 patients were enrolled in this study. Fasting serum levels of total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), apolipoprotein A-I(Apo AI), apolipoprotein B (Apo B),and apolipoprotein AI/B (Apo AI/B) were investigated in simple essential hypertension patients (EH,n=83), patients with coronary heart diseases with normal blood pressure (CHD,n=85), coronary heart diseases complicated with hypertension (EH CHD,n=108),and control group (healthy people without hypertension or coronary heart disease n=106).Results (1)The levels of TC, LDL-C, and Apo B were significantly higher in EH group, CHD group and EH CHD group than those in the control group(P<0.05).The levels of HDL-C, Apo AI and Apo AI/B were significantly lower than those in the control group, (all P<0.05).(2)The level of TG was higher in EH CHD group than in EH group or CHD group when the age was not taken into account.(3)The levels of TC, LDL-C, and TG were significantly higher in EH CHD group aged under 55 yrs than those in EH group and CHD group of the same age.Conclusions Abnormal lipid metabolism in patients with EH is inherent. Dyslipidemia may be aggravated in male patients with coronary heart diseases complicated by hypertension aged under than 55 yrs. Treatment of hyperlipidemia should be considered simultaneouslg with control of blood pressure.