血清中LDL-C、apoB与Syntax积分在稳定型冠心病患者中的相关研究

发布时间：2018-06-12 01:20

  本文选题：SYNTAX积分 + 冠状动脉粥样硬化性心脏病　； 参考：《南方医科大学》2017年硕士论文

【摘要】：背景:冠心病严重威胁人们的生命健康,血脂代谢异常与动脉粥样硬化的发生发展息息相关,LDL-C、apoB、TG、Chol、Lap水平的高低是患冠心病重要危险因素,LDL-C、apoB也是临床干预治疗冠心病的重要靶点。HDL-C、apoA1被誉为抗动脉粥样硬化的预测因子。新提出的以冠状动脉病变的解剖特点进行相应危险分层的SYNTAX积分系统是基于冠脉病变的位置、分叉特点、病变程度、钙化程度等特点来定量评价冠状动脉病变的复杂程度。大量研究表明SYNTAX积分越高,患者的预后越差。LDL-C、apoB的水平是否与SYNTAX积分具有相关性,却少有文献报道。目的:探讨稳定型冠心病患者血清中低密度脂蛋白胆固醇及载脂蛋白B与SYNTAX积分的相关性。方法:本研究入选2014年1月至2014年9月在南方医科大学珠江医院心内科行冠脉造影的患者(排除急性心肌梗死、冠状动脉旁路移植术后、冠脉支架置入术后、肝肾功能不全、肿瘤、感染)。根据SYNTAX积分分为非冠心病组、冠脉狭窄低分组(1≤SS23),冠脉狭窄中分组(23≤SS33)及冠脉狭窄高分组(33≤SS)。应用SPSS20.0统计学软件进行数据分析,比较各组患者在入院后冠脉造影前的血液生化指标(高密度脂蛋白胆固醇、胆固醇、甘油三脂、低密度脂蛋白胆固醇、载脂蛋白A1、载脂蛋白B、肌酸激酶同工酶及血常规等),并与SYNTAX积分作相关性分析。结果:共纳入研究冠脉造影正常153例,冠心病患者395例。冠脉狭窄低分组(n=210 SS=12.4±4.9),冠脉狭窄中分组(n=122 SS=26.7±2.7),冠脉狭窄高分组(n=63 SS=37.2±3.9)。Pearson 相关分析显示:Lpa、LDL-C、apoB、Chol与SYNTAX积分正相关(r=0.132,0.632,0.599,0.313;p0.01),HDL-C、apoA1、apoA1/apoB与SYNTAX积分负相关(r=-0.29,-0.344,-0.561;p0.01);多元线性回归分析显示对于SYNTAX积分影响大小依次为LDL-C、apoB、PDW、Fg、HDL-C、GRA%,标准回归系数依次为:0.397、0.299、-0.123、0.122、0.084、-0.092、0.087、p0.01。结论:LDL-C、apoB、apoA1/apoB、PDW、Fg、HDL-C 是 SYNTAX 的重要预测指标,LDL-C、apoB对冠脉SYNTAX积分影响最大。
[Abstract]:Background: coronary heart disease (CHD) is a serious threat to people's life and health. Abnormal metabolism of blood lipids is closely related to the occurrence and development of atherosclerosis. The level of LDL-Capor Cholla Lap is an important risk factor for coronary heart disease. LDL-Capo B is also an important target of clinical intervention in the treatment of coronary heart disease. HDL-CtropoA1 is regarded as a predictor of anti-atherosclerosis. A new SYNTAX integral system based on the anatomical characteristics of coronary artery disease is proposed to quantitatively evaluate the complexity of coronary artery disease based on the location, bifurcation, severity and calcification of coronary artery disease. A large number of studies have shown that the higher the SYNTAX score, the worse the prognosis. Whether the level of LDL-CapoB is correlated with the SYNTAX score is rarely reported in literature. Objective: to investigate the correlation between serum low density lipoprotein cholesterol, apolipoprotein B and SYNTAX score in patients with stable coronary heart disease. Methods: from January 2014 to September 2014, patients who underwent coronary angiography in the Department of Cardiology, Zhujiang Hospital, Southern Medical University (excluding acute myocardial infarction, coronary artery bypass grafting and coronary stent implantation) were enrolled in this study. Cancer, infection. According to SYNTAX score, no coronary artery disease group, low coronary stenosis group (1 鈮，

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