单项血脂和血脂比值与冠状动脉病变严重程度的相关性

目的探讨单项血脂水平和血脂比值与冠状动脉病变(CAD)严重程度的相关性,为CAD患者的临床防治提供理论依据。方法将384例经冠状动脉造影证实者分为3组:未见异常者(0支)121例为对照组(A组),1-2支病变者149例为B组,3-4支病变者114例为C组。分别分析单项血脂水平和血脂比值与CAD支数的关系。结果①随着CAD支数的增加,高密度脂蛋白胆固醇(HDL-C)逐渐下降,载脂蛋白B(apo B)、总胆固醇(TC)/HDL-C、低密度脂蛋白胆固醇(LDL-C)/HDL-C和apo B/载脂蛋白A(apo A)比值逐渐增加;以C组与A组比较,HDL-C水平、TC/HDL-C和LDL-C/HDL-C比值的改变有显著性差异(P<0.01);C组和B组比较,TC、HDL-C、LDL-C和apo B水平,及TC/HDL-C、TC/apo A、LDL-C/HDL-C和apo B/apo A比值改变均有显著性差异(P<0.05,P<0.01)。②血脂比值比单项血脂水平与CAD支数的相关性更强。③多元逐步回归分析显示:在判断CAD支数方面,TC/HDL-C是影响CAD严重程度最重要的变量,其次为apo B/apo A,其偏回归系数分别为0.190(P<0.01)和0.113(P<0.05)。结论在判断CAD严重程度方面,血脂比值比单项血脂水平更有意义,以TC/HDL-C比值的价值最明显。

Correlation of individual blood lipid and blood lipid ratio with severity of coronary artery disease

Objective To probe into the correlation of individual blood lipid and blood lipid ratio with severity of coronary artery disease(CAD),and to provide theoretical basis for the prevention and treatment of CAD.Methods Totally 384 patients,who were confirmed by coronary artery angiography,were divided into three groups: 121 patients was controls in A group,in whom no branch was involved;149 patients in B group,in whom 1-2 branches were involved;114 patients in C group,in whom 3-4 branches were involved.The relationship of individual blood lipid and blood lipid ratio with CAD was analyzed.Results ① With the increased number of involved branches,high-density lipoprotein cholesterol(HDL-C) level was gradually decreased,apolipoprotein B(apo B) level,tatal cholesterol(TC)/HDL-C,low-density lipoprotein cholesterol(LDL-C)/HDL-C and apo B/apolipoprotein A(apo A) ratio were gradually increased,which had significant differences(all P<0.01).② There was more correlation with involved branches in blood lipid ratio than in individual blood lipid level.③ By plurality stepwise regression analysis,in determining involved branches,TC/HDL C ratio had highly significance difference(P<0.01),and apo B/apo A ratio had significant difference(P<0.05).Conclusion In judging the severity of CAD,blood lipid ratio is more meaningful than individual blood lipid level,and the most important one is TC/HDL C ratio.