【摘要】：目的:探討Non-HDL-C、LDL-C/HDL-C、TC/HDL-C與冠心病發(fā)病之間的相關(guān)性及三者對(duì)冠心病預(yù)后判斷的價(jià)值。方法:收集2012年12月至2013年12月在山西醫(yī)科大學(xué)第一醫(yī)院心內(nèi)科住院并經(jīng)冠脈造影診斷為冠心病患者135例;同期在我科懷疑冠心病入院,經(jīng)冠脈造影檢查示冠脈正常且經(jīng)其他檢查除外冠心病的患者96例為對(duì)照組。記錄冠心病組及對(duì)照組的一般資料(包括性別、年齡、身高、體重、高血壓病史、糖尿病史、吸煙史、飲酒史等),所研究的對(duì)象均于入院后第二天清晨(空腹12小時(shí))抽取靜脈血,測(cè)定兩組的TC、HDL-C、LDL-C,計(jì)算Non-HDL-C、LDL-C/HDL-C、TC/HDL-C比值。分別于患者出院后6個(gè)月、1年進(jìn)行隨訪(fǎng),并抽血化驗(yàn)TC、HDL-C、LDL-C,計(jì)算Non-HDL-C、LDL-C/HDL-C、TC/HDL-C比值,根據(jù)LDL-C是否降至1.8mmol/l或降幅50%分為達(dá)標(biāo)患者和非達(dá)標(biāo)患者,記錄達(dá)標(biāo)者的主要心血管不良事件(Major Adverse Cardiovascular Events,MACE),包括:血運(yùn)重建、再發(fā)心絞痛、心力衰竭、卒中及死亡,分析LDL-C達(dá)標(biāo)患者Non-HDL-C、LDL-C/HDL-C、TC/HDL-C對(duì)冠心病患者預(yù)后的判斷價(jià)值。結(jié)果:1、冠心病患者Non-HDL-C、LDL-C/HDL-C、TC/HDL-C高于對(duì)照組,其中Non-HDL-C、TC/HDL-C與冠心病的發(fā)生呈正相關(guān),P0.05,差異有統(tǒng)計(jì)學(xué)意義;2、多因素Logistic回歸分析表明:半年后LDL-C達(dá)標(biāo)患者M(jìn)ACE事件的發(fā)生同Non-HDL-C、TC/HDL-C呈正相關(guān),P0.05;一年后LDL-C達(dá)標(biāo)患者M(jìn)ACE事件的發(fā)生同Non-HDL-C呈正相關(guān),P0.05,差異有統(tǒng)計(jì)學(xué)意義。結(jié)論:Non-HDL-C、TC/HDL-C與冠心病的發(fā)生相關(guān),其中Non-HDL-C對(duì)冠心病患者的預(yù)后判斷有一定價(jià)值。
[Abstract]:Objective: to investigate the correlation between Non-HDL-C,LDL-C/HDL-C,TC/HDL-C and coronary heart disease (CHD) and the value of the three factors in predicting the prognosis of coronary heart disease (CHD). Methods: from December 2012 to December 2013, 135 patients with coronary heart disease were diagnosed by coronary angiography in the Department of Cardiology, the first Hospital of Shanxi Medical University. At the same time, 96 patients with suspected coronary heart disease were admitted to our department. 96 patients with normal coronary artery disease were found by coronary angiography and other examinations were used as control group. The general data of coronary heart disease group and control group were recorded (including sex, age, height, weight, history of hypertension, history of diabetes, history of smoking, history of drinking, etc.). Venous blood samples were taken from the two groups in the morning of the second day after admission (fasting 12 hours). The TC,HDL-C,LDL-C, of the two groups was measured to calculate the Non-HDL-C,LDL-C/HDL-C,TC/HDL-C ratio. The patients were followed up for 6 months and 1 year after discharge, and the ratio of Non-HDL-C,LDL-C/HDL-C,TC/HDL-C was calculated by TC,HDL-C,LDL-C,. According to whether LDL-C was reduced to 1.8mmol/l or decreased by 50%, it was divided into two groups: standard patients and non-standard patients. The main cardiovascular adverse events (Major Adverse Cardiovascular Events,MACE) were recorded, including: revascularization, recurrent angina pectoris, heart failure. To evaluate the prognostic value of Non-HDL-C,LDL-C/HDL-C,TC/HDL-C in patients with coronary heart disease (CHD) after stroke and death. Results: 1. The Non-HDL-C,LDL-C/HDL-C,TC/HDL-C of patients with coronary heart disease was higher than that of the control group, and the Non-HDL-C,TC/HDL-C was positively correlated with the occurrence of coronary heart disease (P0.05), the difference was statistically significant. 2, multivariate Logistic regression analysis showed that the incidence of MACE events in patients with LDL-C was positively correlated with Non-HDL-C,TC/HDL-C half a year later (P0.05); There was a positive correlation between MACE events and Non-HDL-C in LDL-C patients one year later (P 0.05), the difference was statistically significant. Conclusion: Non-HDL-C,TC/HDL-C is related to the occurrence of coronary heart disease, and Non-HDL-C is valuable in predicting the prognosis of patients with coronary heart disease.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類(lèi)號(hào)】：R541.4

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