冠心病合并代谢综合征患者血脂特点及其与冠脉病变程度的关系

目的：探讨冠心病合并代谢综合征（MS）患者血脂特点及MS对冠脉病变程度的影响。方法：冠状动脉造影确诊为冠心病的患者258例，分为MS以及非MS组，计算其gensini评分并测定血清脂质谱以及其他相关危险因素，评价冠心病合并MS患者血脂特点及其与冠脉病变严重程度的关系。结果：冠心病合并MS组与不合并MS组患者比较，冠脉病变的程度和范围均明显加重（P〈0．01）．MS组血浆甘油三酯（TG）、总胆固醇（TC）、载脂蛋白B（ApoB）以及ApoB／A1比值较未合并MS组的明显增高（P〈0．05～〈0．01）．高密度脂蛋白-胆固醇（HDL-C）显著低于对照组（P〈0．01），而ApoA1以及低密度脂蛋白-胆固醇（LDL-C）并无显著差异，操作特征曲线（ROC）的曲线下面积（AUC）最大者为TG（0．732），其次为ApoB、LDL-C／HDL-C、HDL-C以及ApoB／ApoA1。结论：冠心病合并MS患者存在多种脂质参数异常，与冠状动脉损伤范围以及狭窄密切相关．TG、TC、HDL-C以及ApoB是评价MS较好的脂质参数。

Characteristics of lipid profile in CHD patients with metabolic syndrome and the relationship between metabolic syndrome and the severity of coronary artery stenosis

Objective： To investigate the characteristics of lipid profile in coronary heart disease （CHD） patients with metabolic syndrome （MS） and the relationship between MS and the severity of coronary artery stenosis. Methods： A tatol of 328 hospitalized patients with chest pain underwent coronary angiography, and among these patients, 258 patients were diagnosed as CHD. All these patients were categorized into two groups by with or without metabolic syndrome. The lipid profile and Gensini score of coronary artery were tested. Results： Compared with the CHD without MS group, the patients of CHD with MS had more severe coronary artery stenosis and more lesion vessels （P〈0. 01）.The CHD with MS group had higher levels of total cholesterol （TC）, triglyceride （TG）, apolipoprotein （Apo） B and ApoB/ApoA1 ratio （P〈0.05-〈0.01）, but lower levels of high density lipoprotein cholesterol （HDL-C, P〈 0.01）. However, there was no statistical significance difference in leveld of low density lipoprotein cholesterol （LDL- C） and ApoA1 between these two groups （P〉0. 05）. The ROC curve analysis showed that TG had largest area under curve （AUC, 0. 732）, followed by ApoB, LDL-C/HDL-C, HDL-C and ApoB/ApoA1 ratio. Conclusion： Most parameters of lipid of the patients with CHD and MS are significant differ from those CHD patient without MS, and MS maybe relate to the severity and numbers of coronary artery lesions. TG, TC, HDL-C and ApoB are the good parameters in evaluating MS.