老年高血压合并冠心病患者血脂谱部分指标及比值与冠脉病变严重程度相关性

doi:10.3969/j.issn.1006-6233.2023.05.025

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摘要 目的:探究老年高血压合并冠心病患者血脂谱部分指标及比值与冠脉病变严重程度相关性。方法:纳入2019年1月至2022年1月间125例老年高血压合并冠心病患者作为研究对象,均行冠脉造影(CAG)及空腹血脂[甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、极低密度脂蛋白胆固醇(VLDL-C)]检测,根据CAG检测结果进行Gensini(GS)评分,并分为高分组(n=38)、中分组(n=45)、低分组(n=42)。比较三组患者血脂指标及血脂比值(TG、TC、HDL-C、LDL-C、VLDL-C、TC/TG、TG/HDL-C、TG/LDL-C、LDL-C/HDL-C),分析血脂指标、血脂比值与GS评分的相关性;以GS评分为因变量,血脂指标及血脂比值作为自变量,进行多因素线性回归分析,筛选出经多因素校正后与GS评分仍存在相关性的指标。结果:低分组、中分组、高分组TC、LDL-C均依次升高(P<0.05),组间差异均有统计学意义(P<0.05),三组TG、HDL-C、VLDL-C差异无统计学意义(P>0.05);低分组、中分组、高分组TC/TG、LDL-C/HDL-C依次升高(P<0.05),TG/LDL-C依次降低(P<0.05),组间差异均有统计学意义(P<0.05);Pearson相关性分析结果显示,TC、LDL-C、TC/TG、LDL-C/HDL-C均与GS评分呈正相关(P<0.05),TG/LDL-C与GS评分呈负相关(P<0.05);多元线性回归分析结果显示,LDL-C/HDL-C是GS评分的独立影响因素(P<0.05)。结论:老年高血压合并冠心病患者TC、LDL-C、TC/TG、LDL-C/HDL-C、TG/LDL-C与冠脉病变严重程度具有一定相关性,其中LDL-C/HDL-C可作为评估冠脉病变严重程度的理想指标。

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关键词 ：老年, 高血压, 冠心病, 血脂, 冠脉病变

Abstract：Objective: To explore the correlation between partial indicators and ratios of blood lipid profiles and severity of coronary artery lesion in elderly patients with hypertension and coronary artery disease. Methods: A total of 125 elderly patients with hypertension and coronary artery disease during the period from January 2019 to January 2022 were enrolled as the research subjects. Coronary angiography (CAG) was performed and fasting blood lipids [triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), very low-density lipoprotein cholesterol (VLDL-C)] were detected among all patients. Gensini (GS) score was performed according to the CAG detection results, and the patients were divided into high score group (n=38), medium score group (n=45), and low score group (n=42). The blood lipids indicators and blood lipids ratios (TG, TC, HDL-C, LDL-C, VLDL-C, TC/TG, TG/HDL-C, TG/LDL-C, LDL-C/HDL-C) were compared among the three groups of patients, and the correlation between blood lipids indicators, blood lipids ratios and GS score was analyzed. Taking GS score as the dependent variable and blood lipids indicators and blood lipids ratios as the independent variables, multivariate linear regression analysis was carried out, and the indicators with correlation with GS score after multivariate adjustment were screened out. Results: The TC and LDL-C in low score group, medium score group and high score group were all increased in turn (P<0.05), and the differences between groups were statistically significant (P<0.05), while there were no statistically significant differences in the levels of TG, HDL-C and VLDL-C among the three groups (P>0.05). TC/TG and LDL-C/HDL-C were increased in sequence (P<0.05) while TG/LDL-C was reduced in sequence (P<0.05) in low score group, medium score group, and high score group and the differences between the groups were statistically significant (P<0.05). Pearson correlation analysis showed that TC, LDL-C, TC/TG and LDL-C/HDL-C were positively correlated with GS score (P<0.05), while TG/LDL-C was negatively correlated with GS score (P<0.05). Multivariate linear regression analysis showed that LDL-C/HDL-C was an independent influencing factor of GS score (P<0.05). Conclusion: TC, LDL-C, TC/TG, LDL-C/HDL-C and TG/LDL-C have certain correlation with the severity of coronary artery lesion in elderly patients with hypertension and coronary artery disease. LDL-C/HDL-C can be used as an ideal indicator to assess the severity of coronary artery lesion.

Key words： Elderly Hypertension Coronary artery disease Blood lipids Coronary artery lesion

基金资助:四川省干部保健科研课题,(编号:18BJZ16)

通讯作者: 胡媛媛

引用本文:

林秀, 杨源瑞, 吴婕, 陈博, 胡媛媛, 肖丕娟, 李彩文. 老年高血压合并冠心病患者血脂谱部分指标及比值与冠脉病变严重程度相关性[J]. 河北医学, 2023, 29(5): 826-831.
LIN Xiu, YANG Yuanrui, WU Jie, et al. Correlation between Partial Indicators and Ratios of Blood Lipid Profiles and Severity of Coronary Artery Lesion in Elderly Patients with Hypertension and Coronary Artery Disease. HeBei Med, 2023, 29(5): 826-831.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2023.05.025 或 http://www.hbyxzzs.cn/CN/Y2023/V29/I5/826

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