LDL-C水平正常的老年人颈动脉硬化斑块的形成及稳定分型与TG/HDL、sdLDL-C指标的相关性研究

目的 探讨LDL-C水平正常老年人颈动脉粥样硬化斑块形成及稳定型与TG/HDL、sdLDL-C的相关性。方法 回顾分析 2021年5月至 2022年5月来我院就诊的65岁以上LDL-C＜3.40 mmol/L（130 mg/dL）的老年人群，收集其一般资料及血清学数据。根据有无颈动脉斑块分为无斑块组（57例）和斑块组（131例）。再根据超声SMI检查结果，进一步将斑块组分为新生血管组和无新生血管组。对斑块内新生血管进行SMI分级，进一步讨论分析颈动脉粥样硬化斑块形成和斑块内新生血管形成的血清学危险因素。结果 HDL-C、TG/HDL、sdLDL-C在各组中差异有统计学意义(P<0.05)。斑块组SMI0级、SMI1级、SMI2级患者斑块厚度、sdLDL-C依次升高，不同级别比较差异有统计学意义。使用Spearman相关分析得出LDL-C水平正常的老年人颈动脉斑块SMI分级与斑块厚度, sdLDL-C之间呈正相关（r=0.758,?p<0.01）、（r=0.0.676,?p<0.05）。将斑块厚度，sdLDL-C，HDL-C，TG/HDL作为自变量，而将斑块SMI分级作为因变量进行线性回归分析，斑块厚度的回归系数值为0.779(t=7.116，p=0.000<0.01)，sdLDL-C的回归系数值为0.436(t=2.061，P=0.041<0.05)。结论 HDL-C、TG/HDL、sdLDL-C与LDL-C水平正常的老年人颈动脉斑块形成相关。斑块厚度、sdLDL-C是影响斑块内新生血管的形成，斑块稳定型的危险因素。

Study on the correlation between the formation and stable classification of carotid atherosclerotic plaque and TG/HDL, sdLDL-C in the elderly with normal LDL-C level

Aim To investigate the correlation between carotid atherosclerotic plaque formation and stable type and TG/HDL, sdLDL-C in the elderly with normal LDL-C level. Methods General and serological data of the elderly with LDL-C < 3.60 mmol/l over 65 years old who came to our hospital from May 2021 to may 2022 were retrospectively analyzed. According to the presence or absence of carotid plaque, the patients were divided into two groups: no plaque group (57 cases) and plaque group (131 cases). According to the results of ultrasonic SMI, the plaque group was further divided into neovascularization group and non neovascularization group. To further discuss and analyze the serological risk factors of carotid atherosclerotic plaque formation and neovascularization in plaque, SMI grading was conducted for neovascularization in plaque. Results HDL-C, TG/HDL and sdLDL-C were significantly different in each group (P<0.05). In plaque group, the plaque thickness and sdLDL-C of patients with SMI 0, SMI 1, and SMI 2 increased in turn, and there was a statistically significant difference between different levels. Spearman correlation analysis showed that there was a positive correlation between SMI grade of carotid plaque and plaque thickness, sdLDL-C in the elderly with normal LDL-C level (r=0.758, p<0.01), (r=0.676, p<0.05). The plaque thickness, sdLDL-C, HDL-C, TG/HDL were used as independent variables, and the plaque SMI classification was used as dependent variables for linear regression analysis. The regression coefficient of plaque thickness was 0.779 (t=7.116, p=0.000<0.01), and the regression coefficient of sdLDL-C was 0.436 (t=2.061, P=0.041<0.05).Conclusion HDL-C, TG/HDL, sdLDL-C are related to the formation of arterial plaque in the elderly with normal LDL-C level. Plaque thickness and sdLDL-C are risk factors that affect the formation of neovascularization and plaque stability.