摘要
目的:探讨冠状动脉造影病变程度与血脂成分异常的相关性。方法:选择2001-04至2006-10在我院行冠状动脉造影的470例患者,其中确诊冠心病311例。冠状动脉造影病变程度由三方面表示:造影是否诊断冠心病;冠状动脉狭窄病变支数即0支、1支、2支、3支;冠状动脉狭窄病变Gensini总积分。根据病变积分分为4组,积分为0分的病例159例(积分0分组),积分大于0的病例以3分位点法,分位点积分为21、67,分为3组,0<积分≤21组(104例),21<积分≤67组(104例),67<积分≤197组(103例)。采用单因素,多元线性回归和Logistic多因素回归分析。结果:单因素分析示在病变程度不同的患者中,随病变支数和病变Gensini总积分的增加,各血脂成分异常病例的发生率随之增加。在调整高血压,2型糖尿病,吸烟,性别和高尿酸危险因素后,Logistu多因素分析示各血脂成分异常均增加冠状动脉造影诊断冠心病的危险性,低密度脂蛋白胆固醇(LDL-C)增高(OR=3.661,95%可信区间2.556,5.245,P=0.001),高密度脂蛋白胆固醇(HDL-C)降低(OR=3.473,95%可信区间2.154,5.602,P=0.006),脂蛋白a[LP(a)]增高(OR=3.040,95%可信区间1.752,5.273,P=0.003),载脂蛋白B(Apo B)增高(OR=3.003,95%可信区间2.239,4.341,P=0.007)和载脂蛋白A1(Apo A1)降低(OR=2.746,95%可信区间1.606,4.694,P=0.019)。在调整收缩压水平,空腹血糖水平,年龄、性别和血尿酸水平后,各血脂成分水平与病变积分多元线性回归分析显示,冠状动脉病变积分与LDL-C水平(β系数=0.279;SE:0.052;P=0.001),LP(a)水平(β系数=0.262;SE:0.083;P=0.011)和ApoB水平(β系数=0.417;SE:5.494;P=0.007)呈正相关,与HDL-C水平(β系数=-0.284;SE:0.177;P=0.001)和Apo A1(β系数=-0.465;SE:5.923;P=0.009)水平呈负相关。结论:冠状动脉造影病变程度随各血脂成分异常发生率的增加而加重,故对血脂各异常成分的有效干预在控制冠状动脉粥样硬化具有重要意义。
Objective ：To evaluate the relationship between the dyslipidemia and the severity of coronary atherosclerotic lesion in patients who underwent coronary angiography. Methods：A total of 470 consecutive patients who underwent coronary angiography from April 2001 to October 2006 in our hospital were analyzed. The number of diseased vessels and Gensini score were used as the index to evaluate the extent and severity of coronary artery disease, and the blood lipids of High LDL-C, Low HDL-C, High LP（a）, High Apo B, Low Apo A1 were examined. Data was analyzed by univariate and muhivariate analysis. Resuhs ：Univariate analysis indicated that with the increased number of diseased vessel and Gensini score, the rate of dyslipidemia was increased accordingly. With the adjusted levels of the systolic pressure, fast glucose, uric acid, gender and age, the Linear regression analysis revealed that the Gensini score was positively correlated with the level of LP （a） （ β = 0. 262 ; SE ：0.083;P =0. 011）,the level of LDL-C（ β =0. 279;SE：0.052;P =0. 001）and the level ofApo B（ β =0.417;SE：5.494;P = 0. 007 ） ;was negatively correlated with the level of HDL-C （ β = - 0. 284 ; SE ：0. 177 ; P = 0. 001 ） and the level of Apo A1 （ β = - 0. 465 ; SE ：5.923 ;P = 0. 009）. Conelusion：Dyslipidemia was related to the extent and severity of coronary artery disease.
出处
《中国循环杂志》
CSCD
北大核心
2009年第2期101-104,共4页
Chinese Circulation Journal
关键词
血脂异常
冠状动脉造影
冠状动脉病变程度
Dyslipidemia
Coronary artery angiography
Severity of coronary artery atheroselerotic lesion
