目的探讨小而密低密度脂蛋白(small and dense low-density lipoprotein,sd-LDL)与冠心病合并2型糖尿病患者冠状动脉(简称冠脉)狭窄的相关性。方法收集326例冠心病合并2型糖尿病患者的临床资料、检验结果,根据冠脉造影结果并采用Gensin...目的探讨小而密低密度脂蛋白(small and dense low-density lipoprotein,sd-LDL)与冠心病合并2型糖尿病患者冠状动脉(简称冠脉)狭窄的相关性。方法收集326例冠心病合并2型糖尿病患者的临床资料、检验结果,根据冠脉造影结果并采用Gensini评分,对患者的冠脉进行定量评估。分别根据Gensini评分的平均分及疾病类型,对所有患者分组,并进行统计学分析。结果组间性别、高血压病史、LDL比较,差异无统计学意义;年龄、糖化血红蛋白、sd-LDL比较,差异有统计学意义(P<0.05)。指标sd-LDL(OR=1.129,95%CI 1.075~1.221,P<0.01)与冠脉病变严重程度相关,其预测冠脉狭窄程度的敏感性57%,特异性88%。结论在冠心病合并2型糖尿病患者中,sd-LDL是冠脉病变严重程度的独立危险因素。展开更多
Background It has been reported that increased red blood cell width （RDW）is a marker associated with the presence and adverse outcomes of various cardiovascular diseases. The aim of the present study was prospective...Background It has been reported that increased red blood cell width （RDW）is a marker associated with the presence and adverse outcomes of various cardiovascular diseases. The aim of the present study was prospectively evaluate the severity of coronary artery disease （CAD） and RDW in a large Chinese cohort. Methods A total of 677 consecutive individuals who underwent coronary angiography due to the presence of angina-like chest pain and/or positive treadmill exercise test were enrolled in this study. All patients received coronary angiography and were then divided into two groups based on the results of coronary angiography （CAD group （n=499） and control group （n=178））. The clinical information including classical CAD risk factors and RDW were analyzed to identify their relationship to CAD. The severity of CAD was evaluated by Gensini score and its relationship with RDW was also analyzed. Results Patients with angiographic CAD had significantly elevated RDW levels compared with controls （（12.95±0.77）% vs. （12.73±0.83）%, P=-0.001）. There was a significant positive correlation between RDW and the Gensini score （t=0.37, P 〈0.001）. In multivariate Logistic regression analysis, RDW was demonstrated to be an independent predictor for both angiographic CAD （OR=1.34, 95% Cl 1.02-1.77, P 〈0.05） and for a higher Gensini score （〉13, OR=-2.23, 95% Cf.. 1.62-3.08, P 〈0.001）. In a receiver operating characteristic （ROC） curve analysis, an RDW value of 12.85% was identified as an effective cut-point in predicting the presence or absence of CAD with a sensitivity of 50.0% and a specificity of 65.2%. Conclusion RDW is associated with both presence of CAD and the severity of coronary stenosis, suggesting that it might be a readily available marker for the prediction of CAD and its severity.展开更多
目的探讨血清脂蛋白相关磷脂酶A2(Lp-PLA2)和同型半胱氨酸(HCY)水平检测与冠心病(CHP)患者冠状动脉病变程度的关系。方法选取2017年1月～2018年5月延安大学附属医院经冠状动脉造影确诊的冠心病患者266例为实验组,其中男性161例,平均年龄...目的探讨血清脂蛋白相关磷脂酶A2(Lp-PLA2)和同型半胱氨酸(HCY)水平检测与冠心病(CHP)患者冠状动脉病变程度的关系。方法选取2017年1月～2018年5月延安大学附属医院经冠状动脉造影确诊的冠心病患者266例为实验组,其中男性161例,平均年龄57.3±8.5岁,女性105例,平均年龄61.1±11.6岁,选取同期该院冠状动脉造影阴性的体检者180例为对照组,其中男性97例,平均年龄54.6±10.5岁,女性83例,平均年龄47.5±6.3岁,记录两组性别、年龄、糖尿病史、卒中病史、心肌梗死病史、吸烟史和饮酒史,使用贝克曼AU2700全自动生化分析仪测定两组HCY,Lp-PLA2,空腹血糖(FBG)、三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDLC)和脂蛋白(a)[Lp(a)]水平,分析两组各项指标的差异。秩和检验比较Gensini积分组[低积分组(Gensini积分<14分,n=128),中积分组(Gensini积分14～28分,n=83),高积分组(Gensini积分>28分,n=55)共3组]Lp(a),HCY水平之间的差异,秩和检验比较冠状动脉不同支数病变组[1支病变组(n=87)、2支病变组(n=91)、3支及3支以上病变组(n=88)共3组]Lp(a),HCY水平之间的差异。采用Pearson法分析Gensini积分与Lp-PLA2,HCY水平之间的相关性及LpPLA2与HCY水平之间的相关性。结果实验组与对照组吸烟史、饮酒史及HCY,Lp-PLA2,Lp(a)水平为:59.77%vs38.9%,86.84%vs 76.67%,53.7±21.8μmol/L vs 6.5±4.1μmol/L,366.1±114.3μg/L vs 115.4±48.4μg/L,569±283mg/L vs 107±75.8mg/L,差异均有统计学意义(t或χ~2=7.78～18.75,均P<0.05)。Gensini低积分组、中积分组、高积分组HCY和Lp-PLA2水平为:39.6±20.2μmol/L,50.7±26.4μmol/L,68.5±31.8μmol/L和245.4±88.3μg/L,326.1±104.3μg/L,459.4±113.5μg/L,差异均有统计学意义(Z=5.81,15.25,均P<0.05)。冠状动脉1支病变组、2支病变组、3支及3支以上病变组HCY和Lp-PLA2水平为:48.6±27.2μmol/L,47.8±23μmol/L,74.1±38.6μmol/L和201.4±73.5μg/L,344.1±134.2μg/L展开更多
文摘Background It has been reported that increased red blood cell width （RDW）is a marker associated with the presence and adverse outcomes of various cardiovascular diseases. The aim of the present study was prospectively evaluate the severity of coronary artery disease （CAD） and RDW in a large Chinese cohort. Methods A total of 677 consecutive individuals who underwent coronary angiography due to the presence of angina-like chest pain and/or positive treadmill exercise test were enrolled in this study. All patients received coronary angiography and were then divided into two groups based on the results of coronary angiography （CAD group （n=499） and control group （n=178））. The clinical information including classical CAD risk factors and RDW were analyzed to identify their relationship to CAD. The severity of CAD was evaluated by Gensini score and its relationship with RDW was also analyzed. Results Patients with angiographic CAD had significantly elevated RDW levels compared with controls （（12.95±0.77）% vs. （12.73±0.83）%, P=-0.001）. There was a significant positive correlation between RDW and the Gensini score （t=0.37, P 〈0.001）. In multivariate Logistic regression analysis, RDW was demonstrated to be an independent predictor for both angiographic CAD （OR=1.34, 95% Cl 1.02-1.77, P 〈0.05） and for a higher Gensini score （〉13, OR=-2.23, 95% Cf.. 1.62-3.08, P 〈0.001）. In a receiver operating characteristic （ROC） curve analysis, an RDW value of 12.85% was identified as an effective cut-point in predicting the presence or absence of CAD with a sensitivity of 50.0% and a specificity of 65.2%. Conclusion RDW is associated with both presence of CAD and the severity of coronary stenosis, suggesting that it might be a readily available marker for the prediction of CAD and its severity.
文摘目的探讨血清脂蛋白相关磷脂酶A2(Lp-PLA2)和同型半胱氨酸(HCY)水平检测与冠心病(CHP)患者冠状动脉病变程度的关系。方法选取2017年1月～2018年5月延安大学附属医院经冠状动脉造影确诊的冠心病患者266例为实验组,其中男性161例,平均年龄57.3±8.5岁,女性105例,平均年龄61.1±11.6岁,选取同期该院冠状动脉造影阴性的体检者180例为对照组,其中男性97例,平均年龄54.6±10.5岁,女性83例,平均年龄47.5±6.3岁,记录两组性别、年龄、糖尿病史、卒中病史、心肌梗死病史、吸烟史和饮酒史,使用贝克曼AU2700全自动生化分析仪测定两组HCY,Lp-PLA2,空腹血糖(FBG)、三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDLC)和脂蛋白(a)[Lp(a)]水平,分析两组各项指标的差异。秩和检验比较Gensini积分组[低积分组(Gensini积分<14分,n=128),中积分组(Gensini积分14～28分,n=83),高积分组(Gensini积分>28分,n=55)共3组]Lp(a),HCY水平之间的差异,秩和检验比较冠状动脉不同支数病变组[1支病变组(n=87)、2支病变组(n=91)、3支及3支以上病变组(n=88)共3组]Lp(a),HCY水平之间的差异。采用Pearson法分析Gensini积分与Lp-PLA2,HCY水平之间的相关性及LpPLA2与HCY水平之间的相关性。结果实验组与对照组吸烟史、饮酒史及HCY,Lp-PLA2,Lp(a)水平为:59.77%vs38.9%,86.84%vs 76.67%,53.7±21.8μmol/L vs 6.5±4.1μmol/L,366.1±114.3μg/L vs 115.4±48.4μg/L,569±283mg/L vs 107±75.8mg/L,差异均有统计学意义(t或χ~2=7.78～18.75,均P<0.05)。Gensini低积分组、中积分组、高积分组HCY和Lp-PLA2水平为:39.6±20.2μmol/L,50.7±26.4μmol/L,68.5±31.8μmol/L和245.4±88.3μg/L,326.1±104.3μg/L,459.4±113.5μg/L,差异均有统计学意义(Z=5.81,15.25,均P<0.05)。冠状动脉1支病变组、2支病变组、3支及3支以上病变组HCY和Lp-PLA2水平为:48.6±27.2μmol/L,47.8±23μmol/L,74.1±38.6μmol/L和201.4±73.5μg/L,344.1±134.2μg/L
