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sd-LDL与LDL比值与冠状动脉病变程度关系的研究

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摘要:

目的 研究急性冠脉综合征(ACS)患者小而密低密度脂蛋白(sd-LDL)与低密度脂蛋白(LDL)的比值与冠状动脉(冠脉)病变程度的关系。方法 纳入2020年度于徐州医科大学附属医院心内科住院并行冠脉造影检查的ACS患者210例,其中不稳定性心绞痛(UAP)71例、急性非ST段抬高型心肌梗死(NSTEMI)69例、急性ST段抬高型心肌梗死(STEMI)72例。依据造影结果计算Gensini积分,结果分为第1四分位组(n=52)、第2四分位组(n=53)、第3四分位组(n=53)、第4四分位组(n=52)。测定所有患者血浆sd-LDL、LDL水平,计算出sd-LDL/LDL,分析与冠脉病变严重程度的关系。结果 在Gensini积分四分位分组中,sd-LDL/LDL均随积分的增加呈升高趋势,差异有统计学意义(P<0.05)。Logistic回归分析表明,sd-LDL/LDL(OR=1.845,95%CI:1.441~2.246,P<0.001)是ACS患者冠脉病变程度的独立危险因素。相关性分析显示:sd-LDL/LDL与Gensini积分呈显著正相关(r=0.561,P<0.001),明显高于sd-LDL与Gensini积分的相关程度(r=0.445,P<0.01)。ROC曲线显示,sd-LDL/LDL的曲线下面积0.716,最佳截断值0.461,灵敏度58.5%,特异性77.9%。结论 对于ACS患者,sd-LDL/LDL可能为预测冠脉病变严重程度更敏感的指标,具有更好的临床指导意义。

Abstract:

Objective To study the relationship between ratio of small and dense low-density lipoprotein (sd- LDL) to low-density lipoprotein (LDL, sd-LDL/LDL) and severity of coronary artery lesions in patients with acute coronary syndrome (ACS). Methods ACS patients (n=210) undergone coronary angiography (CAG) were chosen from Department of Cardiology in the Affiliated Hospital of Xuzhou Medical University in 2020, including 71 with unstable angina pectoris (UAP), 69 with acute non-ST-segment elevation myocardial infarction (NSTEMI) and 72 with acute ST segment elevation myocardial infarction (STEMI). After calculating Gensini integrals according to CAG outcomes, the patients were divide into the first quartile group (n=52), the second quartile group (n=53), the third quartile group (n=53) and the fourth quartile group (n=52). The levels of plasma sd-LDL and LDL were detected, sd-LDL/LDL was calculated and relationship between sd-LDL/LDL and severity of coronary artery lesions was analyzed. Results In all quartile groups, sd-LDL/LDL showed an ascending trend with the increase of Gensini integrals (P<0.05). The results of Logistic regression analysis showed that sd-LDL/LDL (OR=1.845, 95%CI: 1.441~2.246, P<0.001) was an independent risk factor of severity of coronary artery lesions in ACS patients. The results of correlation analysis showed that there was a significant positive correlation between sd-LDL/LDL and Gensini integrals (r=0.561, P<0.001), which was significantly higher than the correlation between e between sd- LDL and Gensini integrals (r=0.445, P<0.01). The results of ROC curve analysis showed that AUC of sd-LDL/LDL was 0.716, the optimal cutoff value was 0.461, sensitivity was 58.5% and specificity was 77.9%. Conclusion In ACS patients, sd-LDL/LDL may be a more sensitive index for predicting the severity of coronary artery lesions with a higher clinical significance.

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  • 2008

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