摘要
目的:分析空腹、餐后血脂水平及其波动性(餐后-空腹血脂差值绝对值)与冠脉病变程度的相关性。方法:选择在我院行冠脉造影术患者264例进行横断面研究,根据冠脉造影结果及是否行介入治疗分为斑块组(128例)和介入组(136例)。采用Gensini评分反映冠状动脉病变程度。比较两组间血脂水平及血脂波动性,并分析冠脉病变程度与血脂水平及血脂波动性的相关性。结果:与斑块组比较,介入组男性比例、吸烟比例及腰围均显著增加,餐后-空腹血清LDL-C差值(ΔLDL-C)和餐后-空腹血浆载脂蛋白B差值(ΔApoB)水平均显著升高,餐后-空腹血浆载脂蛋白A1差值(ΔApoA1)水平显著降低,P<0.05或<0.01。Pearson相关分析显示,空腹及餐后血清HDL-C、血浆ApoA1、ΔApoA1水平与Gensini评分呈显著负相关(r=-0.130～-0.218,P<0.05或<0.01),空腹血浆脂蛋白a (Lp a)、空腹及餐后血清游离脂肪酸(FFA)、血清游离脂肪酸差值(ΔFFA)与Gensini评分呈显著正相关(r=0.139～0.176,P<0.05或<0.01)。多元线性回归分析提示餐后血清HDL-C是Gensini评分的保护因素(B=-22.274,P=0.002),餐后血清FFA、ΔFFA、腰围和高脂血症史是Gensini评分的影响因素(B=0.388～24.135,P<0.05或<0.01)。结论:检测冠脉病变患者餐前、餐后血脂水平及其波动性有助于全面、客观地评估血脂和冠脉病变程度的相关性。
Objective: To analyze correlation among fasting (FBL) and postprandial blood lipids (PBL), blood lipid fluctuation (absolute value of PBL-FBL) and severity of coronary artery disease. Methods: Cross-sectional study was performed among 264 patients undergoing coronary angiography (CAG) in our hospital. According to percutaneous coronary intervention (PCI) or not based on CAG results, patients were divided into plaque group (n=128) and PCI group (n=136). Gensini score was used to assess severity of coronary artery disease. Blood lipid levels and its fluctuation were compared between two groups. Correlation among blood lipid levels, blood lipid fluctuation and severity of coronary artery disease were analyzed. Results: Compared with plaque group, there were significant rise in percentages of men and smokers, waist circumference, levels of postprandial-fasting (P-F) serum LDL-C (ΔLDL-C) and P-F plasma apolipoprotein B (ΔApoB), and significant reduction in plasma level of P-F apolipoprotein A1 (ΔApoA1) in PCI group, P <0.05 or <0.01. Pearson correlation analysis indicated that serum fasting and postprandial HDL-C levels, plasma fasting and postprandial levels of ApoA1 and ΔApoA1 were significant inversely correlated with Gensini score ( r =-0.130^-0.218, P <0.05 or <0.01), and levels of plasma fasting lipoprotein a (Lp(a)), serum fasting and postprandial levels of free fatty acid (FFA), serum P-F FFA (ΔFFA) were significant positively correlated with Gensini score ( r =0.139-0.176, P <0.05 or <0.01). Multifactor linear regression analysis indicated that postprandial serum HDL-C was protective factor for Gensini score (B=-22.274, P =0.002), while postprandial serum FFA, ΔFFA, waist circumference and hyperlipidemia history were its influencing factors (B=0.388~24.135, P <0.05 or <0.01). Conclusion: Measurements of fasting and postprandial blood lipid levels and their fluctuation contribute to more comprehensively and objectively assessing blood lipid levels and severity of coronary disease in patients with coronar
作者
朱华芳
顾俊
殷兆芳
许左隽
范例
卓杨
毛承誉
曾华甦
高霖
俞泉
王长谦
ZHU Hua-fang;GU Jun;YIN Zhao-fang;XU Zuo-jun;FAN Li;ZHUO Yang;MAO Cheng-yu;ZENG Hua-su;GAO Lin;YU Quan;WANG Chang-qian(Department of Cardiology,Affiliated Ninth People's Hospital,Medical College of Shanghai Jiaotong University,Shanghai,200011,China)
出处
《心血管康复医学杂志》
CAS
2019年第1期1-5,共5页
Chinese Journal of Cardiovascular Rehabilitation Medicine
基金
上海市科委基础重点项目(14JC1404400)~~
关键词
冠心病
动脉粥样硬化
血脂异常
Coronary disease
Atherosclerosis
Dyslipidemias
