血脂特征对冠状动脉病变程度影响的研究

目的:探讨冠心病患者血脂特征对冠脉病变严重程度的影响。方法:住院患者322例行冠脉造影,冠脉造影正常者68例(21%),确诊冠心病患者254例(79%),其中单支病变组75例(30%),2支病变组83例(32%),3支病变组96例(38%);依据造影结果采用Gensini积分系统对冠脉病变程度进行评分。造影前常规测定总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、甘油三脂。对所得数据资料用SPSS10.0统计软件进行单因素方差分析和多元线性逐步回归法和logistic回归法分析。结果:冠心病组的高密度脂蛋白胆固醇水平明显低于正常组,低密度脂蛋白胆固醇水平高于正常组,差异有统计学意义。各组的总胆固醇、甘油三酯差异无统计学意义。多元线性回归和Logistic回归分析显示高密度脂蛋白胆固醇和低密度脂蛋白胆固醇进入回归方程,高密度脂蛋白胆固醇的OR值较大。结论:低密度脂蛋白胆固醇增高和高密度脂蛋白胆固醇降低是冠状动脉病变及病变程度加重的主要危险因素,其中高密度脂蛋白胆固醇对冠脉病变的影响程度可能强于低密度脂蛋白胆固醇。

Effects of serum lipid characteristic on the severity of coronary artery disease

Objective To evaluate the correlation between serum lipid characteristic and the severity of coronary artery disease in patients undergoing coronary angiography.Methods Three hundred and twenty-two consecutive patients undergoing coronary angiography were selected according to inclusion criteria.The coronary artery disease Gensini scoring system and the number of diseased vessels were used to determine the severity of angiographic coronary artery disease.SPSS10.0 was used to do statistic and analysis of the data.Results Compared with the normal group,the total cholesterol and triglyceride level were not significantly elevated in the other groups.The level of HDL-C in abnormal coronary artery group was lower than that of normal group;the level of LDL-C in abnormal coronary artery group was higher.Logistic regression analysis that showed the important risk factor was various HDL-C.Conclusion The severity of coronary lesions is related with the elevation of LDL-C and the reduction of HDL-C.The reduction of HDL-C may more strongly related with the severity of angiographic coronary artery disease than the elevation of LDL-C.