游离脂肪酸与冠心病患者冠脉病变严重程度的相关性

发布时间：2019-03-16 16:38

【摘要】：目的探讨游离脂肪酸(FFA)与冠心病(CAD)患者冠脉病变程度的相关性。方法选取泰达医院2013年7月4日至2015年2月1日收治的CAD患者,收集了所有研究对象的性别、吸烟史、年龄、高血压、糖尿病、CAD史相关资料,测定相关生化指标。依据冠脉造影的结果,计算分析冠状狭窄程度(GENSINI)积分、三支冠脉病变、狭窄冠脉支数作为分析冠脉病变严重程度的指标。分析不同CAD类型患者FFA的表达水平。多变量分析FFA的不同影响因素。分析不同FFA水平的CAD人群中急性心肌梗死的患病风险。分析不同冠脉病变严重程度的急性心肌梗死患者的FFA水平差异。结果男性和女性年龄、高血压患病率、CAD家族史、超敏C反应蛋白(hs-CRP)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、左室射血分数(LVEF)、载脂蛋白(Apo)A1、吸烟情况、Apo B/Apo A1、FFA水平差异有统计学意义(P0.05)。男性和女性按照CAD类型分组差异有统计学意义(P0.05)。男性和女性中Apo A1和Apo B分别与FFA呈负相关,男性中低密度脂蛋白胆固醇(LDL-C)、CAD类型、甘油三酯(TG)与FFA呈正相关。女性中FFA与LDL-C、糖尿病呈正相关。在男性和女性中,急性心肌梗死组FFA显著高于非急性心肌梗死组(P0.01)。女性的FFA最佳截断值高于男性。男性和女性CAD患者中校正后心肌梗死发病风险高于未校正时的发病风险。急性心肌梗死人群中男性和女性GENSINI积分、三支冠脉病变、狭窄冠脉支数在FFA三等分组差异无统计学意义(P0.05)。结论急性心肌梗死人群FFA水平高于非急性心肌梗死人群,急性心肌梗死人群中冠脉病变的严重程度与FFA水平无关。
[Abstract]:Objective to investigate the relationship between free fatty acid (FFA) (FFA) and coronary artery disease in patients with coronary heart disease (CAD). Methods from July 4, 2013 to February 1, 2015, CAD patients in Taida Hospital were selected. The data of sex, smoking history, age, hypertension, diabetes mellitus and CAD history were collected. According to the results of coronary angiography, the (GENSINI) score of coronary stenosis degree, the three-vessel lesion and the number of coronary artery stenosis were calculated as the indexes to analyze the severity of coronary artery disease. The expression level of FFA in patients with different CAD types was analyzed. Multivariate analysis of different factors affecting FFA. To analyze the risk of acute myocardial infarction (AMI) in CAD population with different FFA levels. The levels of FFA in patients with acute myocardial infarction (AMI) with different severity of coronary artery lesions were analyzed. Results male and female age, prevalence of hypertension, CAD family history, hypersensitivity C-reactive protein (hs-CRP), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), left ventricular ejection fraction (LVEF), apolipoprotein (Apo) A1, Smoking, Apo B/Apo A1, FFA levels were significantly different (P0.05). There was significant difference between male and female according to the type of CAD (P0.05). In male and female, Apo A1 and Apo B were negatively correlated with FFA, while low density lipoprotein cholesterol (LDL-C), CAD) and triglyceride (TG) were positively correlated with FFA in men. There was a positive correlation between FFA and LDL-C, diabetes in women. In male and female, FFA in AMI group was significantly higher than that in non-AMI group (P0.01). The best cut-off value of FFA in women was higher than that in men. The risk of myocardial infarction after correction was higher in men and women with CAD than in uncorrected patients. There was no significant difference in GENSINI score, three-vessel lesion and narrow coronary artery number between male and female patients with acute myocardial infarction in FFA third-class group (P0.05). Conclusion the level of FFA in patients with acute myocardial infarction is higher than that in non-acute myocardial infarction. The severity of coronary artery disease in patients with acute myocardial infarction is not related to the level of FFA.
【作者单位】：天津医科大学中新生态城医院检验科;天津市泰达医院检验科;
【基金】：国家高技术研究发展计划(863计划)子课题(No.2011AA02A111)
【分类号】：R541.4;R446.1

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