血脂代谢紊乱与冠状动脉病变程度关系的研究

目的 :探讨冠状动脉病变与血脂代谢异常的关系。方法 :对 178例胸痛患者行选择性冠状动脉造影 ,按冠状动脉狭窄程度分为正常对照组 5 5例、单支病变组 40例、双支病变组 47例、多支病变组 3 6例。同时测定患者的血脂各成分 ,并对各组指标进行统计学分析及多元线性回归分析。结果 :总胆固醇、低密度脂蛋白胆固醇 (LDL C)、高密度脂蛋白胆固醇 (HDL C)、载脂蛋白A1(apoA1)和载脂蛋白B10 0 (apoB10 0 )在各组之间存在差异 ,尤其是多支病变组与正常对照组之间差异显著。apoA1、HDL C随冠状动脉病变加重而减少 ,总胆固醇、LDL C、apoB10 0 随冠状动脉病变加重而增加。LDL C与冠状动脉狭窄程度呈正相关 ,apoA1与冠状动脉狭窄程度呈负相关。结论 :患者血脂代谢越异常其冠状动脉狭窄程度越严重。LDL C与apoA1在预测冠状动脉狭窄程度方面有重要意义。

Relationship Between Lipid Metabolism Abnormity and Coronary Artery Lesions

Objective:To assess lipid metabolism abnormity associated with coronary artery lesions.Methods:One hundred and seventy-eight patients with chest pain underwent elective coronary angiography.The patients were divided according to the disease degrees into 4 groups:normal control( n =55),single vessel lesion( n =40),double vessel lesion ( n =47)and multivessel lesion( n =36)groups.We also tested for the lipid profiles during the in-hospital period.Results:The total cholesterol,low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol,apolipoprotein A_1 and apolipoprotien B_ 100 were different among groups,especially between multivessel lesion and normal control groups ( p <0.01).The severer the coronary artery lesions,the lower the apoA_1 and high density lipoprotein cholesterol.The severity of coronary lesions was increased with the elevation of total cholesterol,LDL-C and apolipoprotien B_ 100 .The elevation of LDL-C was positively related to the extent of coronary lesions,but apoA_1 negatively.Conclusion:The results suggest that the extent of artery lesions mainly depends on the severity of lipid metabolism abnormity,and LDL-C and apolipoprotein A_1 are reliable predictors of coronary artery lesions.