發(fā)布時間：2018-06-12 01:20

  本文選題：SYNTAX積分 + 冠狀動脈粥樣硬化性心臟病　； 參考：《南方醫(yī)科大學》2017年碩士論文

【摘要】：背景:冠心病嚴重威脅人們的生命健康,血脂代謝異常與動脈粥樣硬化的發(fā)生發(fā)展息息相關,LDL-C、apoB、TG、Chol、Lap水平的高低是患冠心病重要危險因素,LDL-C、apoB也是臨床干預治療冠心病的重要靶點。HDL-C、apoA1被譽為抗動脈粥樣硬化的預測因子。新提出的以冠狀動脈病變的解剖特點進行相應危險分層的SYNTAX積分系統(tǒng)是基于冠脈病變的位置、分叉特點、病變程度、鈣化程度等特點來定量評價冠狀動脈病變的復雜程度。大量研究表明SYNTAX積分越高,患者的預后越差。LDL-C、apoB的水平是否與SYNTAX積分具有相關性,卻少有文獻報道。目的:探討穩(wěn)定型冠心病患者血清中低密度脂蛋白膽固醇及載脂蛋白B與SYNTAX積分的相關性。方法:本研究入選2014年1月至2014年9月在南方醫(yī)科大學珠江醫(yī)院心內(nèi)科行冠脈造影的患者(排除急性心肌梗死、冠狀動脈旁路移植術后、冠脈支架置入術后、肝腎功能不全、腫瘤、感染)。根據(jù)SYNTAX積分分為非冠心病組、冠脈狹窄低分組(1≤SS23),冠脈狹窄中分組(23≤SS33)及冠脈狹窄高分組(33≤SS)。應用SPSS20.0統(tǒng)計學軟件進行數(shù)據(jù)分析,比較各組患者在入院后冠脈造影前的血液生化指標(高密度脂蛋白膽固醇、膽固醇、甘油三脂、低密度脂蛋白膽固醇、載脂蛋白A1、載脂蛋白B、肌酸激酶同工酶及血常規(guī)等),并與SYNTAX積分作相關性分析。結(jié)果:共納入研究冠脈造影正常153例,冠心病患者395例。冠脈狹窄低分組(n=210 SS=12.4±4.9),冠脈狹窄中分組(n=122 SS=26.7±2.7),冠脈狹窄高分組(n=63 SS=37.2±3.9)。Pearson 相關分析顯示:Lpa、LDL-C、apoB、Chol與SYNTAX積分正相關(r=0.132,0.632,0.599,0.313;p0.01),HDL-C、apoA1、apoA1/apoB與SYNTAX積分負相關(r=-0.29,-0.344,-0.561;p0.01);多元線性回歸分析顯示對于SYNTAX積分影響大小依次為LDL-C、apoB、PDW、Fg、HDL-C、GRA%,標準回歸系數(shù)依次為:0.397、0.299、-0.123、0.122、0.084、-0.092、0.087、p0.01。結(jié)論:LDL-C、apoB、apoA1/apoB、PDW、Fg、HDL-C 是 SYNTAX 的重要預測指標,LDL-C、apoB對冠脈SYNTAX積分影響最大。
[Abstract]:Background: coronary heart disease (CHD) is a serious threat to people's life and health. Abnormal metabolism of blood lipids is closely related to the occurrence and development of atherosclerosis. The level of LDL-Capor Cholla Lap is an important risk factor for coronary heart disease. LDL-Capo B is also an important target of clinical intervention in the treatment of coronary heart disease. HDL-CtropoA1 is regarded as a predictor of anti-atherosclerosis. A new SYNTAX integral system based on the anatomical characteristics of coronary artery disease is proposed to quantitatively evaluate the complexity of coronary artery disease based on the location, bifurcation, severity and calcification of coronary artery disease. A large number of studies have shown that the higher the SYNTAX score, the worse the prognosis. Whether the level of LDL-CapoB is correlated with the SYNTAX score is rarely reported in literature. Objective: to investigate the correlation between serum low density lipoprotein cholesterol, apolipoprotein B and SYNTAX score in patients with stable coronary heart disease. Methods: from January 2014 to September 2014, patients who underwent coronary angiography in the Department of Cardiology, Zhujiang Hospital, Southern Medical University (excluding acute myocardial infarction, coronary artery bypass grafting and coronary stent implantation) were enrolled in this study. Cancer, infection. According to SYNTAX score, no coronary artery disease group, low coronary stenosis group (1 鈮，

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