多层螺旋CT评估血脂在冠状动脉粥样斑块变化中的作用

目的:以多层螺旋CT观察血脂,尤其是TG与冠心病患者冠状动脉斑块的变化情况的关系。方法:选择多层螺旋CT及血脂化验检查并复查的患者,观察冠状动脉斑块CT图像的变化并分析与血脂尤其是TG的关系。结果:本组患者中,冠状动脉斑块面积减少者TG水平和LDL-C水平均明显低于斑块面积增加者[1.42(0.92,1.88)vs.1.63(1.26,2.75)mmol/L,P=0.0443;(2.04±0.49)vs.(2.45±0.7)mmol/L,P=0.0091]。逐步回归分析斑块面积增加与TG、LDL-C水平正相关(B=-1.7193,P=0.0014;B=-2.4409,P=0.0352)。结论:TG与LDL-C均与冠状动脉斑块进展有关,LDL-C影响较TG更为明显,但是在当前强调强化控制LDL-C后,TG逐渐成为心血管病剩余风险的重要原因,在临床工作中应该得到重视。

Assessment of relationship between the progression of coronary plaques and serum lipid by mutli-detector computed tomography

Objective：To observe the change of coronary plaque and analyze the relationship between coronary plaques and TG by multi detector computed tomography（MDCT）. Methods： MDCT was performed in 53 patients and rechecked. The level of TG, LDL-C and HDL-C were tested simultaneously. The relationship between the progression of coronary plaques and TG/LDL-C was analyses. Results： The level of TG and LDL- C of the plaque decreased group were significantly lower than those of plaque increased groupl. 42（0. 92,1.88） vs. 1. 63 （1. 26 ,2. 75 ） mmol/L, P=0.0443; （2.04 ±0.49） vs. （2.45±0.7）mmo1/L, P=0.0091. Stepwise regression showed positive correlation between the area of plaque and the level of TG, LDL-C （ P = 0. 0014, P = 0. 0352）. Conclusion： After the LDL-C is well controlled, TG needs to be more valued to reduce residual risk in cardiovascular diseases.