本文選題：非高密度脂蛋白膽固醇　切入點：高密度脂蛋白膽固醇　出處：《青島大學》2017年碩士論文

【摘要】：目的分析冠心病患者的血脂水平,探討非高密度脂蛋白膽固醇和高密度脂蛋白膽固醇比值(non-HDL-C/HDL-C)與冠脈病變程度的相關性。方法入選267例在勝利石油管理局勝利醫院心血管內科住院的患者,男性141例,女性126例,平均62.97±9.66歲。每位患者均記錄性別、年齡、體重指數(BMI)、收縮壓(SBP)、舒張壓(DBP)和有無吸煙史,口服藥物如阿司匹林、β-受體阻滯劑、硝酸酯類、他汀類藥物等。入選患者于入院后次日清晨空腹采血5ml,肝素抗凝,測定高敏C反應蛋白(Hs-CRP)、尿酸(UA)、脂蛋白-α(LP-α)、載脂蛋白A-1(APOA-1)、載脂蛋白B(APOB)、極低密度值蛋白膽固醇(VLDL-C)、總膽固醇(TC)、甘油三脂(TG)和高密度脂蛋白膽固醇(HDL-C),然后分別計算出非高密度脂蛋白膽固醇(non-HDL-C)、non-HDL-C/HDL-C。所有對象均采用經橈/股動脈行左右冠狀動脈造影,左冠脈和右冠脈的主要分支依其主支進行統計。根據冠脈造影結果,按國際通用的冠狀動脈直徑法分為2組,冠狀動脈造影至少一支冠脈血管管腔直徑狹窄≥50%者確定為冠心病,即冠心病組(128例),冠脈造影各支冠脈管腔直徑狹窄50%者為非冠心病患者,即對照組(139例)。依據冠脈病變支數將冠心病組分為單支、雙支和多支病變組,單支病變組:左冠脈、右冠脈任意一支狹窄程度≥50%。雙支病變組:左冠脈、右冠脈任意二支或左主干狹窄程度≥50%。多支病變組:左冠脈、右冠脈均有病變或左主干合并右冠脈病變。根據Gensini評分冠心病組分為輕度、中度和重度病變組,輕度病變組(1分≤Gensini評分23分);中度病變組(23分≤Gensini評分66分);重度病變組(Gensini評分≥66分)。入選患者均采集臨床資料并測定TC、TG、LDL-C、HDL-C等生化指標,計算non-HDL-C/HDL-C,評價non-HDL-C/HDL-C與冠脈病變的相關性。采用SPSS20.0統計軟件進行統計學分析,P0.05有統計學意義。結果1.兩組患者血脂指標比較:2組患者TC、TG、LDL-C、VLDL-C、APOA1、LP-α無顯著性差異(P0.05);HDL-C、APOB、Hs-CRP、UA、LDL-C/HDL-C、non-HDL-C、non-HDL-C/HDL-C、Gensini評分有顯著性差異(P0.05)。2.各亞組non-HDL-C/HDL-C比值比較:亞組分析顯示,non-HDL-C/HDL-C比值隨著病變支數的增加而升高(P0.01)。3.non-HDL-C/HDL-C在不同冠脈病變組差異有顯著性(P0.05)。4.non-HDL-C/HDL-C比值與Gensini評分的相關性分析:Spearman相關分析表明,冠心病組non-HDL-C/HDL-C比值與Gensini評分呈正相關(r=0.403,P0.01)。5.多元線性回歸分析:以Gensini評分為應變量,以年齡、TC、apo B、Hs-CRP、GLU、UA、non-HDL-C/HDL-C比值為自變量,進行多元線性回歸分析顯示,冠心病患者non-HDL-C/HDL-C比值與Gensini評分密切相關(P0.01)。結論non-HDL-C/HDL-C與冠脈病變程度密切相關,是影響冠心病的最顯著的危險因素。
[Abstract]:Objective to analyze the level of blood lipids in patients with coronary heart disease (CHD) and to investigate the relationship between non-HDL-C / HDL-C ratio and the severity of coronary artery disease.Methods A total of 267 patients (male 141, female 126, mean 62.97 鹵9.66 years old) were enrolled in Department of Cardiovascular Medicine, Shengli Hospital, Shengli Petroleum Administration Bureau.Gender, age, body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), smoking history, oral drugs such as aspirin, 尾 -receptor blockers, nitrates and statins were recorded in each patient.Patients were enrolled in the morning after admission fasting blood collection of 5 ml, heparin anticoagulant,The C-reactive protein Hs-CRPU, UAA, LP- 偽, apolipoprotein A-1n APOA-1, apolipoprotein BUAPOB1, very low density protein cholesterol (VLDL-CU), total cholesterol TCU, triglyceride triglyceride (TGG) and high density lipoprotein cholesterol (HDL-CU) were measured, and the non-HDL-C non-HDL-CHDL-CHDL-C were calculated respectively.All subjects underwent left and right coronary angiography via radial / femoral artery, and the main branches of left and right coronary arteries were counted according to their main branches.According to the results of coronary angiography, the coronary artery diameter was divided into two groups according to the international common coronary artery diameter method. Coronary artery disease was determined as coronary artery disease with at least one coronary artery diameter stenosis 鈮，

本文編號：1714937