Kempen H J, van Gent C M, Buytenhek R, Buis B
J Lab Clin Med. 1987 Jan;109(1):19-26.
We examined the association of cholesterol levels in serum lipoprotein fractions, as well as of serum apolipoprotein-AI (apo-AI) and apo-AII levels, with coronary artery stenosis (CAS) and left ventricle function in a group of 43 patients with angina pectoris (33 men and 10 women) subjected to angiography. Cholesterol level in VLDL, LDL, HDL2, and HDL3 fractions was determined after separation of these fractions by density gradient ultracentrifugation. HDL-cholesterol is the sum of cholesterol in HDL2 and HDL3. Cineangiography yielded scores for CAS and for left ventricle ejection fraction (LVEF). On univariate regression CAS was correlated weakly with LDL-cholesterol (positive) and with HDL3-cholesterol and HDL-cholesterol (negative), and more strongly with LDL-cholesterol/HDL-cholesterol (positive), but not with HDL2-cholesterol. LVEF was correlated positively with HDL3-cholesterol, HDL-cholesterol, apo-AI, and apo-AII. Of other "risk factors," none was correlated with CAS, and a history of previous myocardial infarction (PMI) was the only one significantly correlated with LVEF. CAS itself was also correlated negatively with LVEF. In multiple regression analysis with two or three independent variables, the relation of HDL(3)-cholesterol with CAS remained significant when other risk factors were taken into account. LVEF remained related positively with HDL(3)-cholesterol, apo-AI, or apo-AII, when either of them was tested in combination with other risk factors; of these only PMI made a significant independent contribution. Conclusions for this patient group (with low HDL-cholesterol): HDL3-cholesterol, and not HDL2-cholesterol, is informative for CAS; HDL(3)-cholesterol, apo-AI, or apo-AII, as well as CAS and PMI, are associated with LVEF.(ABSTRACT TRUNCATED AT 250 WORDS)
我们在一组43例接受血管造影的心绞痛患者(33例男性和10例女性)中,研究了血清脂蛋白组分中的胆固醇水平以及血清载脂蛋白A-I(apo-AI)和apo-A-II水平与冠状动脉狭窄(CAS)和左心室功能的关系。通过密度梯度超速离心分离这些组分后,测定极低密度脂蛋白(VLDL)、低密度脂蛋白(LDL)、高密度脂蛋白2(HDL2)和高密度脂蛋白3(HDL3)组分中的胆固醇水平。高密度脂蛋白胆固醇是HDL2和HDL3中胆固醇的总和。血管造影电影成像得出CAS和左心室射血分数(LVEF)的评分。单变量回归分析显示,CAS与LDL胆固醇呈弱正相关,与HDL3胆固醇和HDL胆固醇呈负相关,与LDL胆固醇/HDL胆固醇呈强正相关,但与HDL2胆固醇无关。LVEF与HDL3胆固醇、HDL胆固醇、apo-AI和apo-A-II呈正相关。在其他“危险因素”中,没有一个与CAS相关,既往心肌梗死病史(PMI)是唯一与LVEF显著相关的因素。CAS本身也与LVEF呈负相关。在有两个或三个自变量的多变量回归分析中,考虑其他危险因素时,HDL(3)胆固醇与CAS的关系仍然显著。当HDL(3)胆固醇、apo-AI或apo-A-II中的任何一个与其他危险因素联合测试时,LVEF仍然与它们呈正相关;其中只有PMI做出了显著的独立贡献。对该患者组(HDL胆固醇水平低)的结论:HDL3胆固醇而非HDL2胆固醇对CAS有参考价值;HDL(3)胆固醇、apo-AI或apo-A-II以及CAS和PMI与LVEF相关。(摘要截短至250字)