伴或不伴冠心病的高脂血症患者高密度脂蛋白胆固醇变化规律及意义探讨

目的 :探讨伴或不伴冠心病的高脂血症患者高密度脂蛋白胆固醇 (HDL C)变化规律。方法 :回顾性分析 3 75例心肌梗塞患者和 45 8例不伴冠心病的高脂血症患者HDL C变化 ,以及与其他血脂成份的相互影响。结果 :冠心病并高胆固醇血症时 ,HDL C比血脂正常的冠心病患者和正常人群高 ( 1.40± 0 .3 8vs 1.2 3± 0 .5 8和 1.3 0± 0 .3 7,P <0 .0 5 ,单位mmol/L ,下同 ) ;当同时合并高胆固醇和高甘油三酯血症时 ,HDL -C较前者明显降低 ,与血脂正常的冠心病患者相近 ( 1.2 0± 0 .5 1vs 1.2 3± 0 .5 8,P >0 .0 5 )。不伴冠心病的高脂血症患者HDL C变化规律与冠心病患者相同 ,单纯高胆固醇血症HDL -C为 1.42± 0 .42 ,当同时伴有甘油三酯升高时 ,HDL C下降为 1.3 2± 0 .5 2 (P <0 .0 5 ) ,与正常人群 ( 1.3 0± 0 .3 7,P≤ 0 .5 )相近。结论 :高胆固醇血症以及冠心病合并高胆固醇血症HDL C均代偿性升高 ,当同时合并甘油三酯升高时 ,则明显降低HDL C升高的程度

HDL C change regularity and clinical significance of hyperlipidemia patients with or without coronary heart disease

Objective: Exploring HDL-C change regularity and clinical significance of hyperlipidaemia patients with or without coronary heart desease.Methods: Studing retrospectively HCL-C change of 375 patients with coronary heart desease(CHD) and 458 cases of hyperlipidaemia without CHD,and exploring correlations of HCL-C to other plasma lipids and possible mechanism involved in the process of atherosclerosis.Results: HDL-C concentration of patients with CHD was lower than that of hyperlipidaemia without CHD,and normal control population (1.25±0.46 mmol/L vs.1.37±0.43 mmol/L and 1.30±0.37 mmol/L, P <0.05);Then HDL-C of hypercholesterolaemia with CHD was higher than that of CHD with normal plasma lipids and normal controls(1.40±0.38 mmol/L vs.1.23±0.58 mmol/L and 1.30±0.37 mmol/L, P <0.05);When CHD patients were simultaneously hypercholesterolaemia and hypertriglyceridaemia,HDL-C concentration was dropped significantly and analogous with CHD patients with normal plasma lipids(1.20±0.51 mmol/L vs.1.23±0.58 mmol/L, P <0.05),HDL-C change law of hyperlipidaemia without CHD was similar to that of CHD patients.Conclusion: In hypercholesterolaemia with or without CHD,HDL-C rised compensatorily,however when triglyceride increased,triglyceride increased,triglyceridc significanltly dropped rising degree of HDL-C,the machanism involved in the process might be that triglyceride inhibites HDL forming in liver or intestine.