我们的网站为什么显示成这样?

可能因为您的浏览器不支持样式,您可以更新您的浏览器到最新版本,以获取对此功能的支持,访问下面的网站,获取关于浏览器的信息:

|本期目录/Table of Contents|

血脂指标对冠心病危险性预测的性别差异(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2005年第6期
页码:
573-575
栏目:
临床研究
出版日期:
2005-12-05

文章信息/Info

Title:
Sex differences in predictive value of serum lipids as risk factors for coronary disease
作者:
徐凯1 韩雅玲2 佟铭2 杨桂棠2 董伟2 王凡非2
1.第四军医大学西京医院心内科,陕西 西安 710032;2.沈阳军区总医院心内科,辽宁 沈阳 110016
Author(s):
XU Kai1HAN Yaling2TONG Ming2YANG Guitang2DONG Wei2WANG Fanfei2
1.Department of Cardiology, Xijing Hospital,Fourth Military Medical University,Xi′an,Shaanxi 710032,China; 2.Department of Cardiology, General Hospital of Shenyang Military Command,Shenyang,Liaoning 110016,China
关键词:
冠状动脉疾病血脂冠状动脉造影性别
Keywords:
coronary diseaseserum lipidcoronary angiograhysex
分类号:
R541.4
DOI:
-
文献标识码:
A
摘要:
目的 通过对血脂指标与冠心病发病之间关系的探讨,阐明各种血脂指标对冠心病危险性的预测价值是否存在性别差异。方法 对1997年9月~2004年6月在我科行选择性冠状动脉造影术(SCA)的患者资料进行回顾性分析。根据造影结果各分为两组:冠心病(CAD+)组和对照(CAD-)组。造影前1 d空腹抽取静脉血,测定血脂水平。结果 共分析6806例患者,其中男性4881例,女性1925例。根据造影结果分组,女性CAD-组有811例,CAD+组有1114例。男性CAD-组有1255例,CAD+组有3626例。女性两组间的总胆固醇(TC)、甘油三酯(TG)、载脂蛋白B(apoB)、高密度脂蛋白胆固醇(HDLC)、低密度脂蛋白胆固醇(LDLC)及非高密度脂蛋白胆固醇(nonHDLC) 相差非常显著(均P<0.01),而载脂蛋白A(apoA)及TC/HDLC无显著差异(均P>0.05);男性两组间的TC (P<0.01)、HDLC (P<0.01)、LDLC (P=0.05)及nonHDLC (P<0.01) 相差显著,而TG、apoA、apoB及TC/HDLC无显著差异(均P>0.05)。应用Logistic回归模型对年龄及各项血脂指标进行多因素分析。女性患者只有apoB进入方程,男性患者中只有TC进入方程。结论 预示冠心病发病的最有价值的血脂指标在男性及女性分别是血清TC和apoB。
Abstract:
AIM To elucidate whether there are differences between men and women in predictive power of serum lipids as risk factors for coronary artery disease(CAD) . METHODS The total of 6806 patients undergoing coronary angiography were studied from September 1997 to June 2004 in our department. Patients were divided into two groups:Group 1 (CAD+) consisted of patients at least one main coronary artery with ≥50% stenosis and group 2 (CAD-) patients with none of the coronary arteries significantly obstructed (<50%). Before coronary angiography, blood samples after overnight fasting were collected for the determination of serum lipids including cholesterol (TC), triglycerides (TG), low density lipoprotein cholesterol (LDLC), high density lipoprotein (HDL), apolipoprotein A(apoA) and apolipoprotein A(apoB). RESULTS CAD+ women (n=1114) had higher plasma levels of apoB (P<0.01), TC (P<0.01), TG(P<0.01),LDLC (P=0.003),nonHDLC (P<0.01) and lower HDLC (P<0.01) than CAD- women (n=811).CAD+ men (n=3626) had higher plasma concentrations of TC(P<0.01), LDLC (P=0.05), nonHDLC (P<0.01) and lower levels of HDLC (P<0.01) than CAD-men (n=1255). Only apoB and TC were found to be independent risk factors for CAD in women and men respectively among lipid components by Logistic regression analysis. CONCLSION ApoB (for women ) and TC (for men) are more valuable than other lipid parameters in predicting coronary disease.

参考文献/References

[1] Fukushima H, Sugiyama S, Honda O, et al. Prognostic value of remnantlike lipoprotein particle levels in patients with coronary artery disease and type II diabetes mellitus[J]. J Am Coll Cardiol,2004,43(12):2219-2224.

[2] von Muhlen D, Langer RD, BarrettConnor E. Sex and time differences in the associations of non-highdensity lipoprotein cholesterol versus other lipid and lipoprotein factors in the prediction of cardiovascular death (The Rancho Bernardo Study)[J]. Am J Cardiol, 2003,91(11):1311-1315.

[3] Castanho VS, Oliveira LS, Pinheiro HP, et al. Sex differences in risk factors for coronary heart disease: a study in a Brazilian population[J]. BMC Public Health, 2001,1(1):3.

[4] Ford ES, Mokdad AH, Giles WH, et al. Serum total cholesterol concentrations and awareness, treatment, and control of hypercholesterolemia among US adults: findings from the National Health and Nutrition Examination Survey, 1999 to 2000[J]. Circulation, 2003,107(17):2185-2189.

[5]Nielsen NE, Olsson AG, Swahn E. Plasma lipoprotein particle concentrations in postmenopausal women with unstable coronary artery disease. Analysis of diagnostic accuracy using receiver operating characteristics[J]. J Intern Med, 2000,247(1):43-52.

[6]Ballantyne CM, Andrews TC, Hsia JA, et al. Correlation of nonhighdensity lipoprotein cholesterol with apolipoprotein B: effect of 5 hydroxymethylglutaryl coenzyme A reductase inhibitors on nonhighdensity lipoprotein cholesterol levels[J]. Am J Cardiol, 2001,88(3):265-269.

备注/Memo

备注/Memo:
收稿日期:2004-09-06.作者简介:徐凯,主治医师,博士生Tel:(024)23051599 Email:xukui2001@sina.com
更新日期/Last Update: 2010-01-06