非高密度脂蛋白胆固醇在评估血糖升高冠心病患者中的应用价值-东南大学学报医学版

非高密度脂蛋白胆固醇在评估血糖升高冠心病患者中的应用价值

单位：1. 蚌埠医学院第一附属医院心外科, 安徽蚌埠 233000;
2. 蚌埠市第三人民医院心内科, 安徽蚌埠 233000

分类号：R541.4

出版年·卷·期（页码）：2017·36·第一期（70-73）

摘要：

目的：通过回顾性分析血糖升高的冠心病（CHD）患者血脂的变化，探讨非高密度脂蛋白胆固醇（non-HDL-C）与冠脉病变程度的关系。方法：以空腹血糖值6.1mmol·L^-1为界，将474例CHD患者分为血糖升高组和血糖正常组；两组再分为单支、双支及3支冠脉病变亚组。比较血脂指标在两组中的变化，分析non-HDL-C与冠脉病变程度的相关性。结果：血糖升高组的non-HDL-C水平高于血糖正常组（P<0.05）；两组non-HDL-C水平均与冠脉病变支数及冠脉病变严重程度显著相关（P<0.001）。结论：无论CHD患者血糖是否异常，non-HDL-C水平与冠脉严重程度均显著相关，并较LDL-C强。Non-HDL-C水平可作为评估血糖异常CHD患者病变程度的可靠指标。

Objective:To retrospectively analyze the changes of blood lipid and discuss the relationship between non-high-density lipoprotein cholesterol(non-HDL-C)and coronary disease severity in coronary heart disease(CHD)patients with elevated blood glucose.Methods:Based on fasting blood sugar levels of 6.1mmol·L^-1,474 cases of CHD patients were divided into normal blood glucose group and elevated blood glucose group,then each group was divided into three subgroups:single,double and three branches coronary artery lesion group.Changes of blood lipid index in both groups were compared and the correlation between non-HDL-C and coronary artery lesion group were analyzed. Results:(1)The level of non-HDL-C in the elevated blood glucose group was higher than that in normal glucose group (P<0.05);(2)The non-HDL-C levels of the two groups were significantly correlated with the number of coronary lesions and the severity of coronary artery disease (P<0.001).Conclusion:Whether the blood glucose level of CHD patients is normal,the association between non-HDL-C and coronary artery severity is significant and the association of non-HDL-C is more significant than that of LDL-C.The level of non-HDL-C can be a reliability index for evaluating the lesion severity of the CHD patients with abnormal blood glucose.

参考文献：

[1] Third report of the national cholesterol education program (NCEP) expert panel on detection,evaluation,and treatment of high blood cholesterol in adults (adult treatment panel Ⅲ) final report[J].Circulation,2002,106:3143-3421.
[2] ANDERSON T J,GRÉGOIRE J,HEGELE R A,et al.2012 update of the Canadian Cardiovascular Society guidelines for the diagnosis and treatment of dyslipidemia for the prevention of cardiovascular disease in the adult[J].Can J Cardiol,2013,29(2):151-167.
[3] JACOBSON T A,ITO M K,MAKI KC,et al.National lipid association recommendations for patient-centered management of dyslipidemia:Part 1-executive summary[J].J Clin Lipidol,2014,8(5):473-488.
[4] 胡大一,潘长玉.中国住院CHD患者糖代谢异常研究——中国心脏调查[J].中华内分泌代谢杂志,2006,1(22):7-10.
[5] MARK L,VALLEJO-VAZ A J,REIBER I,et al.Non-HDL cholesterol goal attainment and its relationship with triglyceride concentrations among diabetic subjects with cardiovascular disease:A nationwide survey of 2 674 individuals in Hungary[J].Atherosclerosis,2015,241(1):62-68.
[6] KITAMURA A,NODA H,NAKAMURA M,et al.Association between non-high-density lipoprotein cholesterol levels and the incidence of coronary heart disease among Japanese:the Circulatory Risk in Communities Study (CIRCS)[J].J Atheroscler Thromb,2011,18(6):454-463.
[7] SIGDEL M,YADAV B K,GYAWALI P,et al.Non-high density lipoprotein cholesterol versus low density lipoprotein cholesterol as a discriminating factor for myocardial infarction[J].BMC Res Notes,2012,5(1):640.
[8] ROSENSON R S,DAVIDSON M H,POURFARZIB R.Underappreciated opportunities for low-density lipoprotein management in patients with cardiometabolic residual risk[J].Atherosclerosis,2010,213(1):1-7.
[9] SASAKI J,YOKOYAMA M,MATSUZAKI M,et al.Relationship between coronary artery disease and non-HDL-C,and effect of highly purified EPA on the risk of coronary artery disease in hypercholesterolemic patients treated with statins:sub-analysis of the Japan EPA Lipid Intervention Study (JELIS)[J].J Atheroscler Thromb,2012,19(2):194-204.
[10] DUNN F L.Management of dyslipidemia in people with type 2 diabetes mellitus[J].Rev Endocr Metab Dis,2010,11(1):41-51.

服务与反馈：

【文章下载】【发表评论】【查看评论】【加入收藏】

提示：您还未登录，请登录！点此登录