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目的探讨餐后血脂浓度与冠状动脉粥样硬化性心脏病(冠心病)患者冠状动脉病变严重程度的关系。方法选取昆明医科大学第二附属医心血管内科二病区2014年12月至2015年6月163例行冠状动脉造影检查的患者,住院期间测定常规饮食情况下空腹及早餐后4 h的血清三酰甘油(triacylglycerol,TG)、总胆固醇(total cholesterol,TC)、低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)、高密度脂蛋白胆固醇(high-density lipoprotein cholesterol,HDL-C)、非高密度脂蛋白(non-high-density lipoprotein,non-HDL)、脂蛋白a[lipoprotein a,LP(a)]、载脂蛋白(apolipoproteins,Apo)A及Apo B浓度;对患者行冠状动脉造影术检查冠状动脉病变情况,根据造影结果进行Syntax评分再评估冠状动脉病变严重程度;统计分析餐后血脂浓度与冠心病患者冠状动脉病变程度的相关性。结果冠心病患者餐后血清TG及HDL-C浓度均明显高于空腹状态,差异有统计学意义(P<0.05);随着Syntax评分的增加,餐后血清HDL-C、LP(a)及Apo A浓度逐步降低,差异有统计学意义(P<0.05);血清TC、TG、LDL-C及non-HDL浓度则随着Syntax评分的增加而升高,但差异未达到统计学意义(P>0.05)。餐后Apo A及HDL-C与Syntax评分呈负相关(r=-0.207、-0.157;β=-14.373、-7.533;P<0.05)。结论冠心病患者餐后Apo A及HDL-C与冠状动脉病变严重程度(Syntax评分)呈负相关,可能跟空腹状态一样对冠状动脉具有保护作用。Syntax
Objective To investigate the relationship between the postprandial blood lipid concentration and the severity of coronary artery disease in patients with coronary atherosclerotic heart disease (CHD). Methods A total of 163 patients undergoing coronary angiography between December 2014 and June 2015 were enrolled in the Second Affiliated Hospital of Kunming Medical University from December 2014 to June 2015. Serum III (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) , Non-high-density lipoprotein (non-HDL), lipoprotein a (LP), apolipoprotein (Apo) Arterial angiography coronary lesions, angiography results according to the Syntax score to assess the severity of coronary lesions; statistical analysis of postprandial blood lipids and coronary artery disease severity of coronary artery disease correlation. Results Postprandial serum TG and HDL-C levels in patients with coronary heart disease were significantly higher than those in fasting state (P <0.05). With the increase of Syntax score, postprandial serum HDL-C, LP (a) and (P <0.05). The levels of TC, TG, LDL-C and non-HDL increased with the increase of Syntax score, but the difference did not reach statistical significance (P > 0.05). Postprandial Apo A and HDL-C were negatively correlated with Syntax scores (r = -0.207, -0.157; β = -14.373, -7.533; P <0.05). Conclusion The postprandial Apo A and HDL-C levels in patients with coronary heart disease were negatively correlated with the severity of coronary artery disease (Syntax score), which may have the same effect on the coronary arteries as the fasting state. Syntax