目的 探讨冠心病患者冠脉靶病变血管重构指数(RI)与血清LDL-C和HDL-C的关系.方法 本研究共纳入81例冠心病患者,通过IVUS对靶病变血管进行检测,测量出靶病变部位及参考段血管的外弹力膜面积并计算出重构指数.搜集患者年龄、性别、LDL-C、HDL-C等资料.结果 通过多元线性回归分析发现,冠心病患者吸烟及LDL-C与RI之间差异有统计学意义(P=0.03),且LDL-C与RI呈正相关(R^2=0.051,P=0.043).对于冠心病合并糖尿病患者,只有HDL-C与RI之间差异有统计学意义(P=-0.03),且HDL-C与RI呈负相关(R^2=0.236,P=0.026).结论 冠心病患者血清LDL-C水平与RI呈正相关,随着LDL-C逐渐升高,RI逐渐增大,冠脉更偏向于正性重构.斑块越不稳定,对于冠心病合并糖尿病患者,血清HDL-C水平与RI呈负相关,即随着HDL-C逐渐升高,RI逐渐减小,冠脉更偏向于负性重构.
Objective To research the pattern of the remodeling in target lesion artery, and discuss the correlation between LDL-C, HDL-C and remodeling index (RI) in patients with coronary artery disease. Methods This study included 81 patients with coronary artery disease. The external elastic membrane at target lesion site and reference site were detected by IVUS, and the RI was calculated. The information of patients including age, gender, LDL-C, HDL-C were collected. Results The multiple linear regression analysis showed that RI was correlated with smoking and LDL-C (P〈0.05), and there was a positive correlation between RI and LDL-C (R^2=0.051, P=0.043). For patients with coronary artery disease and diabetes meliitus, that the RI was correlated with HDL-C (P〈0.05), and there was a negative correlation with HDL-C and RI (R^2=0.236, P= 0.026). Conclusion In patients with coronary artery disease, RI were positively related to the level of serum LDL-C. As LDL-C rising, RI increasing, coronary prefer to positive remodeling, plaque is more unstable. In patients with coronary heart disease and diabetes mellitus, there was a negatively correlation between RI and levels of serum HDL-C. As HDL-C rising, RI decreasing, coronary prefer to negative remodeling, plaque is more stable.