潮汕地区绝经后女性血脂水平与冠状动脉病变程度的关系

摘要

目的：探讨潮汕地区绝经后女性冠心病患者血脂异常的患病情况，以及血脂水平与冠状动脉SYNTAX Score（SS）的相关性。方法：选取2014年12月-2016年1月汕头市中心医院接受冠状动脉造影术的潮汕地区绝经后的女性患者260例，均进行SS评分。将患者分为四组，对照组：冠脉血管正常；低危组：0分32分。比较四组血脂异常患病率、空腹高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、总胆固醇（TC）、甘油三酯（TG）水平，将血脂水平与SS进行相关分析和回归分析。结果：绝经后女性低、中、高危组年龄、糖尿病患病率均高于对照组（P<0.05）。冠心病绝经后女性血脂异常患病率为79.4%，高胆固醇血症、高甘油三脂血症、高低密度脂蛋白血症、低高密度脂蛋白血症患病率分别为28.9%、20.6%、11.1%、5.6%。中危组LDL-C、TC水平明显高于对照组和低危组（P<0.05）。校正年龄、高血压、糖尿病、吸烟史、LDL-C与SS评分呈正相关（r=0.309，P<0.001）。多因素线性回归分析：LDL-C、年龄、糖尿病与SS呈正相关（R2=0.317，F=39.556，P<0.001）。结论：潮汕地区绝经后女性冠心病患者的血脂异常患病率高。潮汕地区绝经后女性LDL-C与SS评分呈正相关关系，提示LDL-C与冠状动脉病变严重程度的密切相关。%Objective:To determine the morbidity rate of dyslipidemia and the relationship between lipid profile and SYNTAX Score (SS) in postmenopausal women with coronary artery diseases(CAD) from Chaoshan Area.Method:A cohort of 260 postmenopausal women from Chaoshan Area was enrolled who underwent coronary angiography in Shantou Central Hospital from December 2014 to January 2016.The postmenopausal women were divided into control group( normal coronary arteries,n=80),mild group(032,n=37) based on SS.The fasting lipid serum levels(HDL-C, LDL-C,TC,TG) and the morbidity rate of dyslipidemia were compared among the four groups.The relationship between fasting lipid serum levels and SS was analyzed using correlation and multiple linear regression analysis. Result:The ages and the morbidity rates of diabetes mellitus(DM) of the mild, moderate and severe groups were significantly higher than those of the control group(P<0.05).The morbidity rate of dyslipidemia postmenopausal women with CAD was 79.4%(MRTC=28.9%,MRTG=20.6%,MRLDL-C=11.1%,MRHDL-C=5.6%).The LDL-C and TC serum levels in the moderate groups were higher than those of the control group and the mild group (P<0.05).Adjusted ages, hypertension, DM and smoking, the correlation coefficient(r=0.309,P<0.001) between LDL-C serum levels and SS.A multiple linear regression analysis showd that SS increased with the increased of LDL-C serum levels,age and DM( R2=0.317,F=39.556,P<0.001).Conclusion:The morbidity rate of dyslipidemia postmenopausal women with CAD from Chaoshan Area is high.The LDL-C serum levels are significantly related to SS which evaluated the severity of coronary atherosclerosis in the postmenopausal women from Chaoshan Area.