首页|血栓调节蛋白和非高密度脂蛋白胆固醇与冠心病患者升主动脉弹性功能及冠脉病变程度的关系

血栓调节蛋白和非高密度脂蛋白胆固醇与冠心病患者升主动脉弹性功能及冠脉病变程度的关系

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目的 探讨血栓调节蛋白(TM)、非高密度脂蛋白胆固醇(non-HDL-C)的水平变化与冠心病(CHD)患者升主动脉弹性功能及冠脉病变程度的关系。方法 选取榆林市第一医院2018年1月至2022年12月经冠脉造影检查确诊的冠心病患者147例作为CHD组,另外选取在本院接受健康体检且未发生冠脉病变的志愿者90例作为对照组。对比两组的血脂[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)]、升主动脉弹性功能参数[动脉扩张度(AD)、动脉僵硬指数(ASI)]、TM、non-HDL-C水平等指标,并按照冠脉病变支数进行分层分析,采用线性相关分析法分析TM、non-HDL-C与Gensini评分、升主动脉弹性功能参数的关系。结果 CHD组患者的血清TG、TC、LDL-C、TM、non-HDL-C水平显著高于对照组,HDL-C水平低于对照组,差异均有统计学意义(均P<0。05)。CHD组患者的升主动脉ASI显著高于对照组,AD低于对照组,差异均有统计学意义(均P<0。05)。多支冠脉病变的CHD患者血清TG、TC、LDL-C、TM、non-HDL-C水平显著高于双支、单支冠脉病变患者,HDL-C水平低于双支、单支冠脉病变患者,差异均有统计学意义(均P<0。05);双支冠脉病变的CHD患者血清TM、non-HDL-C水平显著高于单支冠脉病变患者,HDL-C水平低于单支冠脉病变患者,差异均有统计学意义(均P<0。05)。多支冠脉病变的CHD患者ASI显著高于双支、单支冠脉病变患者,AD低于双支、单支冠脉病变患者,差异均有统计学意义(均P<0。05);双支冠脉病变的CHD患者ASI显著高于单支冠脉病变患者,AD低于单支冠脉病变患者,差异均有统计学意义(均P<0。05)。CHD患者TM、non-HDL-C与AD呈显著的负相关关系(均P<0。05),与ASI、Gensini评分呈显著的正相关关系(均P<0。05)。结论 CHD患者的TM、non-HDL-C水平显著升高,升主动脉弹性功能降低,TM、non-HDL-C与冠脉弹性功能及冠脉病变严重程度有关。
The relationship between thrombomodulin and non high-density lipoprotein cholesterol with ascending aortic elastic function and degree of coronary artery disease in patients with coronary heart disease
Objective To explore the relationship between changes in levels of thrombomodulin(TM)and non high-density lipoprotein cholesterol(non-HDL-C)with ascending aortic elastic function and degree of coronary artery disease(CHD)in patients with coronary heart disease(CHD).Methods A total of 147 patients with coronary heart disease diagnosed through coronary angiography at Yulin First Hospital from January 2018 to December 2022 were selected as the CHD group.In addition,90 volunteers who underwent health examinations at our hospital and did not experience coronary artery disease were selected as the control group.Two groups were compared in terms of blood lipids[triglycerides(TG),total cholesterol(TC),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C)],ascending aortic elastic function parameters[arterial dilation(AD),arterial stiffness index(ASI)],TM,non HDL-C levels,and other indicators,and stratified analysis was conducted according to the number of coronary lesions.The linear correlation analysis method was used to analyze the relationship between TM,non-HDL-C,Gensini score,and ascending aortic elastic function parameters.Results The serum levels of TG,TC,LDL-C,TM,and non HDL-C in the CHD group were significantly higher than those in the control group,while the HDL-C levels were lower than those in the control group,with statistical significance(all P<0.05).The ASI of the ascending aorta in the CHD group was significantly higher than that in the control group,while the AD was lower than that in the control group,and the differences were statistically significant(all P<0.05).The serum levels of TG,TC,LDL-C,TM,and non HDL-C in CHD patients with multiple coronary artery lesions were significantly higher than those in patients with dual or single coronary artery lesions,and the HDL-C levels were lower than those in patients with dual or single coronary artery lesions,with statistical significance(all P<0.05);The serum levels of TM and non HDL-C in CHD patients with dual coronary artery disease were significantly higher than those in single coronary artery disease patients,and the HDL-C levels were lower than those in single coronary artery disease patients,with statistical significance(all P<0.05).The ASI of CHD patients with multiple coronary artery lesions was significantly higher than that of patients with dual or single coronary artery lesions,and the AD was lower than that of patients with dual or single coronary artery lesions,with statistical significance(all P<0.05);The ASI of CHD patients with dual coronary artery disease was significantly higher than that of patients with single coronary artery disease,and the AD was lower than that of patients with single coronary artery disease,with statistical significance(all P<0.05).The TM,non HDL-C levels in CHD patients were significantly negatively correlated with AD(all P<0.05),and positively correlated with ASI and Gensini scores(all P<0.05).Conclusions The levels of TM and non HDL-C in CHD patients significantly increase,and the ascending aortic elasticity function was decreased.TM and non HDL-C are related to coronary elasticity function and the severity of coronary artery disease.

Coronary diseaseAscending aortaVascular elasticityThrombomodulinCholesterol

张瑜、李季、蓝剑、刘彩成

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榆林市第一医院绥德医院心内科,榆林 718000

冠心病 升主动脉 血管弹性 血栓调节蛋白 胆固醇

2024

中国医师杂志
中华医学会 湖南省医学会

中国医师杂志

CSTPCD
影响因子:0.876
ISSN:1008-1372
年,卷(期):2024.26(3)
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