48例冠心病患者血脂测定临床分析

目的调查冠心病(CHD)患者血脂代谢状况,探讨血脂变化在触发CHD发生发展中的作用及临床意义。方法用日立7020全自动生化分析仪检测48例CHD患者和50例健康对照者血清总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)和脂蛋白(a)[Lp(a)]水平。TC、TG测定采用氧化酶法,HDL-C、LDL-C测定采用直接法,Lp(a)测定采用胶乳增强免疫比浊法。结果 CHD患者TC(5.28±1.07)mmol/L、TG(1.83±0.60)mmol/L、LDL-C(3.41±1.29)mmol/L、Lp(a)(269±170)mg/L,明显比对照组[(4.25±0.93)mmol/L、(1.30±0.43)mmol/L、(2.51±0.87)mmol/L、(138±96)mg/L]高,差异有统计学意义(P0.001);而CHD患者HDL-C[(1.15±0.34)mmol/L]却比对照组[(1.32±0.43)mmol/L]低,差异也有统计学意义(P0.05)。结论 CHD患者存在不同程度的血脂代谢紊乱,TC、TG、LDL-C升高和HDL-C降低将触发CHD的发生和发展。

Clinical analysis of determination of serumlipid in 48 cases of coronary heart disease

Objective To investigate the condition of lipids metabolism in the patients with coronary heart disease （CHD） and to study the clinical significance and role of changes of serum lipids on triggering occurrence and development of CHD.Methods The levels of total cholesterol （TC）,triglyceride （TG）,high density lipoprotein cholesterol （HDL-C）,low density lipoprotein cholesterol （LDL-C） and lipoprotein a [Lp（a）] were measured with HITACHI 7020 automatic biochemistry analyzer in 48 patients with CHD and in 50 healthy subjects,respectively.TC and TG were detected by enzymatic oxidation.HDL-C,LDL-C were measured by the direct method.Lp（a） was measured by latex enhanced immunoturbidimetric assay.Results CHD patients had significantly higher levels of TC,TG,LDL-C and Lp（a） （5.28±1.07）mmol/L,（1.83±0.60）mmol/L,（3.41±1.29）mmol/L and （269±170）mg/L,respectively） compared to those in controls （4.25±0.93）mmol/L,（1.30±0.43）mmol/L,（2.51±0.87）mmol/L,（138±96）mg/L （P0.001）.However,the concentration of HDL-C of CHD group was obviously lower than that of controls [（1.15±0.34）mmol/L vs （1.32±0.43）mmol/L,P0.05].Conclusion There is a metabolic disorder of serum lipids in the patients with CHD.It will result in occurrence and development of CHD which elevates levels of TC,TG,LDL-C and Lp（a） and lowers concentration of HDL-C.