The Relationship Between Dyslipidemia And Oronary Artery Lesions In Patients With Coronary Eart Disease (CHD)

Objective:we analyze the serum lipid levels of patients with CHD and individuals with-Out CHD who all have be diagnosed definitely by coronary artery angiography（CAG），and To evaluate dyslipidemia between patients with CHD and individuals without CHD，meanwhile To discuss the relationship between dyslipidemia with the degree andscope of coronary artery lesions in patients with CHD.Methods:Choose291Hospitalized patients randomly from Yijishan hospital affiliateddirectly to wannan medical college between December2010to March2013,who allreceived CAG examination.Among those individuals,211cases were diagnosed withCHD definitively（At least one major epicardial coranory vessel or its main branches withdiameter stenosis> or=50%），80cases were diagnosed without CHD.According to theGensini score,all patients with CHD were divided into three groups, namely the Gensiniscore <20divided into The first group (69cases),20</=Gensini score <45for thesecond group (70cases), Gensini score>/=45as the third group(72cases);According tothe results analysed by the above grouping, furtherly,all patients with CHD weredivided into two groups, the Gensini score <45divided into the first group, the Gensiniscore>or=45as the second group;According to the number of Lesion involving incoranary arterys, patients with CHD were divided into three groups, namely single lesiongroup (61cases), double branch lesions (73cases) and multivessel disease group (77cases) respectively;Before the CAG, Fasting serum lipid levels for At least12hours were measured,including total cholesterol (TC), triglycerides(TG), high-density lipoproteincholesterol (HDL-C), low density lipoprotein(LDL-C), apolipoprotein A1(APOA1),apolipoprotein B(APOB),lipoprotein a(LPa).Finally useing SPSS17.0statistical softwareto analyze each lipid levels;Results:1.compared with the non-CHD group, the age of CHD group was obviouslyhigher (P <0.05), and CHD group is given priority to with male, and having Statisticalsignificance. There were significant statistical differences between the two groups forHDL, APOA1, APOB,LDL/HDL, TC/HDL, Ln (LDL),Ln (LPa) and Ln(APOB/APOA1)(APOB,P<0.05, else all P<0.01).Compared with the non-CHD group,the levels of HDLand APOA1in CHD group were significantly reduced(P<0.05),On the other hand thelevels of APOB, LDL/HDL,TC/HDL,Ln(LDL),Ln(LPa) and Ln(APOB/APOA1) weresignificantly increased(P<0.05), but for Ln(TC) and Ln(TG) there was no significantStatistical differences between the two groups (P>0.05);2.Comparing the three groups divided into according to the Gensini score we found:there was no significant Statistical differences in the gender ratios(P=0.962) and age(thefirst group,61.57+/-9.56，the second group of65.23+/-9.51, and the third group of63.86+/-10.00, P=0.082);there were no significant statistical differences among thethree groups for APOB、Ln(TG),otherwise there were significant statistical differencesamong the three groups for TC、HDL、APOA1、LDL/HDL、APOB/APOA1、TC/HDL、Ln(LDL)、Ln(LPa),But for which,comparing the first group and the second group,therewere no significant Statistical differences for all lipid levels and ratios of lipid,whilecomparing the first and the third group there was only for HDL no significance ofdifference, yet there were for the others all,in the same way comparing the second and thethe significance of difference;3.when we divided the patients with CHD into two groups, respectively the Gensini score<45points group and the Gensini score>or=45points group,and compared with theGensini score <45points group,we found that the latter group having obvious higher levels of TC,LDL/HDL, APOB/APOA1,TC/HDL,Ln(LDL) and Ln(LPa),whilesignificant lower levels of HDL and APOA1,and all the results had significantly statisticalsignificance;4.Comparing the three groups divided into according to the number of Lesion involvingin coranary vessels,found that there were significant difference among the threegroups(single lesion group, double branch lesionsand multivessel disease group) inage,but no in the gender ratios;By analysis of TC、 HDL、 APOA1、 APOB、APOB/APOA1、LDL/HDL、TC/HDL、Ln(TG)、Ln(LDL)、Ln（LPa）using One-ANOVAamong the three groups,found that:with the increasing of the vessels involved in lesion,the LDL/HDL and TC/HDL increased significantly (all P <0.05), while there were nostatistically significant difference among the three groups for TC, HDL, APOA1, APOB,APOB/APOA1, Ln (TG),Ln(LDL) and Ln (LPa).5.By bivariate correlation analysis between age,all lipid indexs, lipid ratios respectivelyand Ln (Gensini score), there were no correlation between age, HDL, Ln (TG) andLn(Gensini score), while Ln(TC), APOA1, APOB, Ln (APOB/APOA1),LDL/HDL,TC/HDL, Ln(LDL) and Ln(LPa) all were related with Ln(Gensini score), butthe relevant degree(r) all are lower, in addition to APOA1was negatively related withLn(Gensini score), others all were positively related with Ln (Gensini score).Conclusion:1.Fasting TG is not a independent risk for CHD,while low HDL, lowAPOA1, APOB, LDL, LPa are independent risks for CHD, but the APOB/APOA1，LDL/HDL and TC/HDL ratio are also good predictors of CHD.2.As ratio of APOB/APOA1,LDL/HDL and TC/HDL increasing, the degree of coronaryartery lesions is more severe in patients with CHD.3.As ratio of LDL/HDL and TC/HDL increasing,more coronary arteries with lesions areinvolved in patients with CHD,but the ratio of APOB/APOA1is meaningless to predictthe coronary arteries with lesions.