上海交通大学学报（医学版）

上海交通大学学报（医学版）

• 论著（临床研究） • 上一篇    下一篇

残余胆固醇在急性冠脉综合征患者评估中的应用

汪萍，毛剑虹，陆一闻，沈立松   

  1. 上海交通大学 医学院附属新华医院检验科，上海 200092
  • 出版日期:2016-12-28 发布日期:2016-12-29
  • 通讯作者: 沈立松，电子信箱：lisongshen@hotmail.com。
  • 作者简介:汪萍（1974—），女，副主任技师，硕士；电子信箱：pink_wangping@163.com。
  • 基金资助:

    上海市科委生物医药领域产学研医合作项目（14DZ1940200, 14DZ1940203）

Application of residual cholesterol to the assessment of patients with acute coronary syndrome

WANG Ping, MAO Jian-hong, LU Yi-wen, SHEN Li-song   

  1. Department of Laboratory Medicine, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
  • Online:2016-12-28 Published:2016-12-29
  • Supported by:

    Production-Study-Research-Medical Cooperation Science and Technology Commission of Shanghai Municipality, 14DZ1940200, 14DZ1940203

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摘要：

目的 ·研究残余胆固醇（RC）水平对急性冠脉综合征（ACS）患者的临床应用评估。方法 ·利用生化法检测293例稳定型心绞痛患者、115例非高血压的ACS患者、72例合并高血压的ACS患者、91例疾病对照组患者和152例表观健康人群的总胆固醇（TC）、高密度脂蛋白胆固醇（HDL-Ch）和低密度脂蛋白胆固醇（LDL-Ch）水平。RC由TC减去HDL-Ch和LDL-Ch得到，非高密度脂蛋白胆固醇（non-HDL-Ch）由TC减去HDL-Ch得到。对RC与TC、LDL-Ch、HDL-Ch、non-HDL-Ch的相关性进行分析。利用ROC曲线分析RC、LDL-Ch、non-HDL-Ch在鉴别稳定型心绞痛组和ACS中的作用。结果 · ACS组、ACS合并高血压组的RC均显著高于稳定型心绞痛组（P<0.05）。RC与TC、LDL-Ch、HDL-Ch和non-HDL-Ch相关性均有统计学意义（均P<0.01）。稳定型心绞痛及ACS患者的ROC曲线分析表明， RC对于鉴别该2种疾病最佳，以下依次为non-HDL-Ch、LDL-Ch、TC、HDL-Ch。结论 · RC水平在缺血性心脏病患者中明显升高，可作为ACS与稳定型心绞痛的鉴别指标。

关键词: 残余胆固醇, 急性冠脉综合征, 缺血性心脏病

Abstract:

Objective · To investigate the clinical application of serum remnant cholesterol (RC) to the assessment of patients with acute coronary syndrome (ACS). Methods · We enrolled 293 patients with stable angina (SA), 115 patients with non-hypertensive ACS, 72 patients with hypertensive ACS, 91 patients as controls, and 152 healthy controls. Levels of total cholesterol (TC), HDL- cholesterol (HDL-Ch), and LDL-Ch were measured with biochemistry method. RC was given by subtracting LDL-Ch and HDL-Ch from TC and non-HDL-Ch was given by subtracting HDL-Ch from TC. The correlations of RC with TC, LDL-Ch, HDL-Ch, and non-HDL-Ch were analyzed. ROC curves were used to analyze the application of RC, LDL-Ch, HDL-Ch, and non-HDL-Ch for differentiating SA and ACS. Results · The RC level was significantly higher in the ACS group and the hypertensive ACS group than in the SA group (P<0.05). Correlations of RC with TC, LDL-Ch, HDL-Ch, and non-HDL-Ch were statistically significant (P<0.01). The ROC curve analysis showed that RC was the best for differentiating SA and ACS, followed by non-HDL-Ch, LDL-Ch, TC, and HDL-Ch. Conclusion · Remnant cholesterol is significantly elevated in the patients with ischemic heart disease and can be used for differentiating ACS and stable angina.

Key words:  remnant cholesterol, ischemic heart disease, acute coronary syndrome