低密度脂蛋白胆固醇和糖化血红蛋白水平与冠状动脉病变程度的相关性分析

摘要

Objective To study the correlations between the levels of low-density lipoprotein cholesterol (LDL-C)and hemoglobin A1c (HbA1c)and the severity of coronary artery disease. Methods According to the results of coronary angiography,238 patients with suspected coronary heart disease were divided into coronary heart disease (CHD)group (n = 162)and non-CHD group (n=76).Patients with CHD were subdivided into group A (LDL-C≤2.4 mmol·L-1 ,n=98)and group B (LDL-C>2.4 mmol·L-1 n=64).The levels of total cholesterol (TC),triacylg-lycerol (TG),LDL-C,high-density lipoprotein cholesterol (HDL-C)and HbA1c were measured in all patients.The severity of coronary artery disease was assessed using the Gensini score,and the correlations between TC,TG,HDL-C,LDL-C and HbA1c levels and Gensini score were ana-lyzed.Results Compared with non-CHD group,levels of TC,TG,LDL-C and HbA1c increased and levels of HDL-C decreased in CHD group (P <0.05).No correlations were found between TC and TG levels and Gensini score in CHD group (r =0.079 and 0.101,respectively;P >0.05). However,Gensini score was negatively correlated with HDL-C level (r=-0.168,P <0.05),and positively correlated with LDL-C and HbA1c levels (r=0.692 and 0.689,respectively;P <0.01). In addition,Gensini score was positively correlated with HbA1c level in group B (r=0.381,P <0.01),but was not correlated with HbA1c level in group A (r=0.195,P >0.05).Conclusion The levels of LDL-C and HbA1c are independently associated with the severity of coronary artery disease.Simultaneous increase in the levels of LDL-C and HbA1c is a significant predictor of the severity of coronary artery disease.%目的：探讨冠心病患者低密度脂蛋白胆固醇（LDL-C）、糖化血红蛋白（HbA1c）水平与冠状动脉病变程度的关系及其临床意义。方法将238例拟诊冠心病患者根据冠状动脉造影结果分为2组：冠心病组（162例）和非冠心病组（76例）。冠心病组又根据 LDL-C 水平分为2个亚组：A 组（LDL-C≤2．4 mmol·L－1，98例）和 B 组（LDL-C＞2．4 mmol·L－1，64例）。冠心病组、非冠心病组分别测定总胆固醇（TC）、三酰甘油（TG）、LDL-C、高密度脂蛋白胆固醇（HDL-C）和 HbA1c 水平。对冠心病组冠状动脉病变程度进行 Gensini 评分，分析冠心病组 TC、TG、HDL-C、LDL-C、HbA1c 水平与 Gensini 得分的相关性，分析 A、B 2组 HbA1c 水平与 Gensini 得分的相关性。结果与非冠心病组比较，冠心病组总胆固醇、TG、LDL-C 和 HbA1c 水平均明显升高，HDL-C 水平明显降低（均 P ＜0．05）。相关性分析结果显示，冠心病组 TC、TG 水平与 Gensini 得分无相关性（r ＝0．079、0．101，均 P ＞0．05）， HDL-C 水平与 Gensini 得分呈负相关（r＝－0．168，P ＜0．05），LDL-C、HbA1c 水平与 Gensini 得分均呈正相关（r＝0．692、0．689，均 P ＜0．01）。A 组 HbA1c 水平与 Gensini 得分无相关性（r＝0．195，P ＞0．05），B 组 HbA1c 水平与Gensini 得分呈正相关（r＝0．381，P ＜0．01）。结论LDL-C、HbA1c 水平是冠状动脉病变程度的独立危险因素， LDL-C、HbA1c 同时升高对冠脉病变程度有较高的预测价值。