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目的探讨冠脉造影患者冠状动脉狭窄程度和高密度脂蛋白(High-density lipoprotein,HDL)亚类的关系。方法 1抽取2013年至2015年因疑诊冠心病(Coronary Heart Disease,CHD)入住我院老年医学科、心内科行冠状动脉造影(Coronary arteriography,CAG)的患者361例,通过CAG确诊为CHD患者(至少有一支冠状动脉或分支狭窄>50%)237例,其中男138例,女99例,平均年龄(60.31±8.59),未诊断CHD患者124例,男50例,女74例,平均年龄(59.22±13.23);2抽取患者空腹12 h静脉血,选择双向电泳加免疫印迹检测法24h内测定HDL亚类,对患者冠脉造影结果(采用Gensini评分)评价冠状动脉狭窄程度;3计量资料用χ軘±s表示,定性资料用χ2检验,两组比较采用独立样本的t检验,logisitic回归分析与冠心病相关因素,有序Ordinal回归分析与冠状动脉狭窄程度的关系。结果 1 CHD组中中、重度患者组Preβ1-HDL、HDL3b较非CHD组明显增高(p<0.05),CHD组中轻、中、重度患者组HDL3c较非CHD组明显增高(p<0.05),而HDL2b较非CHD组显著减少(p<0.05),随着冠状动脉狭窄程度的增加,Preβ1-HDL、HDL3b、HDL3c出现增高趋势,而HDL2b则降低;2二元Logistic回归分析,HDL亚类中Preβ1-HDL,HDL3b,HDL3c与CHD呈正相关(p<0.05),HDL2b与CHD呈负相关;有序Ordinal回归,Preβ1-HDL与冠状动脉狭窄程度呈正相关,HDL2b与冠状动脉狭窄程度呈负相关。结论 Preβ1-HDL、HDL3b高对冠心病有风险,HDL2b是冠心病保护因素,在临床诊断治疗中,HDL2b值有可能做为冠心病预测因素,Preβ1-HDL、HDL2b可为预测和诊断CHD提供重要参考依据,冠心病的防治不仅要改善和促进胆固醇逆转运还要调节血脂及调整HDL亚类的构成比。
Objective To investigate the relationship between the degree of coronary artery stenosis and the high-density lipoprotein (HDL) subclass in coronary angiography. Method 1 From 2013 to 2015, 361 patients admitted to our department of geriatric medicine and cardiology underwent coronary angiography (CAG) in our hospital due to coronary heart disease (CHD) were enrolled. Patients with CHD were diagnosed by CAG (At least one coronary artery or branch stenosis> 50%) 237 cases, including 138 males and 99 females, the average age (60.31 ± 8.59), 124 patients without diagnosis of CHD, 50 males and 74 females, mean age (59.22 ± 13.23) .2 Venous blood samples were taken from patients on fasting for 12 h. HDL subclasses were determined by two-dimensional electrophoresis and Western blotting in 24 h. Coronary angiography (Gensini score) was used to evaluate coronary stenosis. 3 Measurement data Χ 軘 ± s said, qualitative data with χ2 test, two groups were compared using independent samples t-test, logisitic regression analysis and coronary heart disease related factors, ordinal Ordinal regression analysis of the relationship between the severity of coronary artery stenosis. Results The levels of Preβ1-HDL and HDL3b in moderate and severe CHD patients were significantly higher than those of non-CHD patients (p <0.05). HDL3c in CHD patients was significantly higher than that of non-CHD patients (p <0.05) HDL2b was significantly lower than that of non-CHD group (p <0.05). Preβ1-HDL, HDL3b and HDL3c increased with the increase of coronary artery stenosis, while HDL2b decreased. 2 Binary Logistic regression analysis, HDL subclass Preβ1-HDL, HDL3b and HDL3c were positively correlated with CHD (p <0.05), while HDL2b was negatively correlated with CHD. Ordinal regression and Preβ1-HDL were positively correlated with coronary stenosis. HDL2b was negatively correlated with coronary stenosis. Conclusions Prebeta1-HDL and HDL3b high risk of coronary heart disease, HDL2b is a protective factor of coronary heart disease, in the clinical diagnosis and treatment, HDL2b value may be used as a predictor of coronary heart disease, Prebeta1-HDL, HDL2b may provide important for the prediction and diagnosis of CHD Reference basis, prevention and treatment of coronary heart disease not only to improve and promote the reverse cholesterol transport but also regulate blood lipids and adjust the constituent ratio of HDL subclasses.