脂代谢异常与动脉粥样硬化状况的关系

目的研究血脂水平(血脂全套)与动脉粥样硬化的关系,评价高脂血症以及其他危险因素在颈动脉粥样硬化形成中的作用.方法将178例患者分为血脂正常组和血脂异常组(根据不同血脂成分的异常变化,分成6个组),进行颈动脉超声检测,以双侧颈动脉内膜-中层厚度的最大值(IMTmax)作为评价颈动脉粥样硬化严重程度的指标,并进行颈动脉粥样硬化的危险因素分析.结果部分血脂异常组IMTmax与血脂正常组存在差异(P＜0.01,P＜0.05),不同IMTmax组段间的部分血脂成分水平(TC、LDL、APO-B、HDL和APO-A)存在差异(P＜0.01,P＜0.05),且随IMTmax的增厚而呈升、降趋势.颈动脉粥样硬化的多因素分析表明,高胆固醇血症是动脉粥样硬化的主要危险因素之一,而其他成分如LDL、APO-B、LP-a也在动脉粥样硬化的发生、发展中起着不可忽视的作用.而HDL、APO-A有对抗动脉粥样硬化,保护血管的作用,此二者血清水平的降低增强了升高的TC、LDL、TG、VLDL的促动脉粥样硬化的作用.结论血脂异常是动脉粥样硬化的发生、发展的重要原因之一,而积极控制血脂水平和其他动脉粥样硬化易患因素是防止、延缓动脉粥样硬化发生、发展的必要措施.

The role of hyperlipidemia in atherosclerosis

Objective To reveal the relationship between the levels of serum lipid components and carotid inter-medial thickness (IMT), and evaluate the role of hyperlipidemia in atherosclerosis. Methods 30 subjects with normal serum lipids and 148 subjects with abnormal serum lipids (divided into 6 groups according to the abnormality of lipid components) were examined with carotid sonography. The maximum inter-medial thickness of bilateral carotid arteries was measured. The serum level of lipid components and other risk factors of atherosclerosis were tested at the meantime. Results The differences of IMT max of carotid arteries between normal serum lipid group and abnormal lipid components level groups were significant(P<0.05). Further analysis showed that the differences of serum levels of some lipid components (TC, LDL, APO-B, HDL and APO-A) among different IMTmax intervals were significant(P<0.05)while the IMTmax increased in response to the increasing or decreasing of those lipid components levels. Multiple variables regressive analysis showed that LDL which functioned as the transport substance of TC, HDL which function was to help the decreasing of TC, APO-B and LP-a are main risk factors of atherosclerosis accompanied other factors such as age, BMI, sex, glucose, and DBP. Conclusion As hyperlipidemia is one of the important risk factors of atherosclerosis, effective serum lipid lowing therapy as well as measures to control other factors is necessary to protect atherosclerosis or delay its progress.