Abstract：Objective: To explore the relationship between the distribution of plasma low-density lipoprotein (LDL) subtypes and the severity, prognosis of senile coronary heart disease (SCHD) patients. Methods: A total of 192 SCHD patients who were hospitalized in Cardiology Department of our hospital from December 2018 to October 2019 were selected as the research objects (observation group), and 189 cases with normal coronary artery examination were selected as the control group. The levels of blood lipid were measured by automatic biochemical analyzer; the LDL subtypes were electrophoretic separated by linear polyacrylamide gel. The quantitative analysis of LDL subtypes was completed by high-precision scanning; the correlation between plasma LDL3, small and dense LDL (sdLDL) and Gensini score was analyzed by Pearson method. Results: The levels of plasma triglyceride (TG), total cholesterol (TC) and LDL cholesterol (LDL-C), LDL3, ldl4, ldl5, ldl6, ldl7 and sdLDL in the observation group were significantly higher than those in the control group, and the level of plasma high density lipoprotein cholesterol (HDL-C) was significantly lower than that in the control group (P<0.05). The levels of plasma LDL3 and sdLDL in single vessel group, double vessel group and three vessel group were significantly increased in turn (P<0.05). The levels of plasma LDL3 and sdLDL in the high Gensini score group were significantly higher than those in the low and middle score groups, the levels of plasma LDL3 and sdLDL in middle Gensini score group were significantly higher than those in low score group (P<0.05). The levels of plasma LDL3 and sdLDL in SCHD patients were positively correlated with Gensini score (r / P = 0.536/0.000, 0.521/0.000). The levels of plasma LDL3 and sdLDL in poor prognosis group were significantly higher than those in good prognosis group (P<0.05). Logistic regression analysis showed that LDL3, sdLDL and Cr were independent risk factors for the severity of SCHD patients. while age, sdLDL and Gensini score were independent risk factors for the prognosis of SCHD patients (P<0.05). Conclusion: The levels of LDL3 and sdLDL in different subtypes of plasma LDL in SCHD patients are significantly increased, which are related to the increase of the number of diseased branches, the increase of Gensini score and the occurrence of MACE.
[1] Musunuru K,Kathiresan S.Genetics of common,complex coronary artery disease[J].Cell,2019,177(1):132~145. [2] 郭小亚,张华,张培培,等.心脏康复对老年冠心病患者的影响及现状[J].中国医师杂志,2019,21(7):1108~1111. [3] Chieng D,Pang J,Ellis KL,et al.Elevated lipoprotein (a) and low-density lipoprotein cholesterol as predictors of the severity and complexity of angiographic lesions in patients with premature coronary artery disease[J].Clin Lipidol,2018,12(4):1019~1026. [4] 安宁,邹德玲.小而密低密度脂蛋白与冠心病的研究进展[J].中国动脉硬化杂志,2019,27(7):639~644. [5] 李强,卜艳玲,关悦瑶.丹参酮对老年冠心病的疗效及对血脂和血清tPA、PAI水平的影响[J].中国地方病防治杂志,2017,32(10):1158,1160. [6] 胡学俊,方存明,郑亚国,等.血清胱抑素C与冠心病患者预后的相关性[J].江苏医药,2019,45(12):1233~1235. [7] Faroux L,Guimaraes L,Wintzer-Wehekind J,et al.Coronary artery disease and transcatheter aortic valve replacement:JACC state-of-the-art review[J].Am Coll Cardiol,2019,74(3):362~372. [8] Goyfman M,Chaus A,Dabbous F,et al.The correlation of dyslipidemia with the extent of coronary artery disease in the multiethnic study of atherosclerosis[J].Lipids,2018,2018(1):1~10. [9] He P,Fan S,Guan J,et al.Mediation analysis for the relationship between dyslipidemia and coronary artery disease via hypersensitive C-reactive protein in a case-control study[J].Coron Artery Dis,2020,31(7):613~619. [10] 高颖,邢智,马依彤.冠心病人群免疫指标、炎症指标和血脂的比较及补体C3、C4与HDL-C的相关性分析[J].新疆医科大学学报,2019,42(3):25~28. [11] Stein R,Ferrari F,Scolari F.Genetics,dyslipidemia,and cardiovascular disease:new insights[J].Curr Cardiol Rep,2019,21(8):1~12. [12] 陆静芬,赵金燕,陈旭,等.小而密低密度脂蛋白胆固醇和HbA1C对年龄≥65岁2型糖尿病患者心脑血管事件发生的预测价值[J].中华检验医学杂志,2020,43(3):250~254. [13] Tani S,Takahashi A,Nagao K,et al.Association of lecithin-cholesterol acyltransferase activity measured as a serum cholesterol esterification rate and low-density lipoprotein heterogeneity with cardiovascular risk:a cross-sectional study[J].Heart and vessels,2016,31(6):831~840. [14] 刘广彬,夏光伟,龚开政,等.低密度脂蛋白亚型与冠状动脉病变程度的关系[J].中国动脉硬化杂志,2019,27(12):1053~1057.
2021, Vol. 27 
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