不同年龄和性别血清非高密度脂蛋白胆固醇与冠状动脉病变的关系探讨

目的：探讨不同年龄和性别的冠心病患者血清非高密度脂蛋白胆固醇（non-HDL-C）水平与冠状动脉病变的关系。方法：选取530例行选择性冠状动脉造影的患者,分别测定总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL-C）和低密度脂蛋白胆固醇（LDL-C）,并计算出non-HDL-C的含量（non-HDL-C=TC-HDL-C）。结果：①冠脉造影阳性组血清non-HDL-C显著高于阴性组（P〈0.01）,并且随冠脉病变支数增多,血清non-HDL-C水平也增高。②Logistic回归结果显示在冠造阳性和阴性、1支病变与多支病变的比较中non-HDL-C的OR值分别是OR=1.032（95%C I1.011-1.049）和OR=1.007（95%C I1.002-1.012）,略强于LDL-C;③冠状动脉病变支数、程度与脂质成份的逐步回归显示,non-HDL-C是年龄小于55岁的男性患者组中最主要的相关因素。结论：血清non-HDL-C是一项与冠状动脉病变相关的,且优于LDL-C的指标,特别在年龄小于55岁的男性患者中。这将对临床降non-HDL-C治疗时,选择合适人群提供有力的依据。

Study on association between non-HDL-C and coronary artery lesions

Objective:To study the value of non-high-density lipoprotein cholesterol(non-HDL-C) in the assessment of severity of coronary artery lesions and to compare its predictive value with that of low-density lipoprotein cholesterol(LDL-C).Methods:Total cholesterol(TC),triglyceride(TG),high-density lipoprotein cholesterol(HDL-C) were measured in 530 patients with selecting coronary angiograph.Then non-HDL-C were calculated with the formula:non-HDL-C=TC-HDL-C.Results:1.Serum non-HDL-C level in the positive angiograph group was significantly higher than that in the negative group (P<0.01),increased with the number of affected vessels.2.Logistic regression analysis showed that the OR value of non-HDL-C is 1.032(95%CI 1.011-1.049) for the positive angiograph group and the negative group,1.007(95%CI 1.002-1.012) between one vessel lesion and multi-vessel lesions,better than LDL-C.3.The multivariant stepwise regression analysis of the vessel number,severity and lipids of coronary artery lesions showed that non-HDL-C was the best indicator in the male patients group who were under the age of 55 years.Conclusion:Serum non-HDL-C level is related to the severity of coronary artery lesions which is superior to LDL-C,especially in men under the age of 55 years.This will benefit to lipid-lowering strategy in selecting proper individuals.