Sugrue D D, Thompson G R, Oakley C M, Trayner I M, Steiner R E
Br Med J (Clin Res Ed). 1981 Nov 21;283(6303):1358-60. doi: 10.1136/bmj.283.6303.1358.
An angiographic comparison was made of the extent and severity of coronary artery disease in 25 patients with heterozygous familial hypercholesterolaemia and 25 normocholesterolaemic patients with coronary artery disease in whom heavy cigarette consumption was the chief risk factor. The patients with familial hypercholesterolaemia were younger and included a much higher proportion of women than the smokers. Significantly more patients with familial hypercholesterolaemia had disease of the main stem of the left coronary artery (eight v none, p less than 0.05) and triple-vessel disease (18 v four, p less than 0.05). Disease affecting only distal vessels occurred in five smokers, whereas all the patients with familial hypercholesterolaemia showed a combination of proximal and distal lesions. These findings suggest that cigarette smoking and familial hypercholesterolaemia predispose to different patterns of coronary atheroma. Early coronary angiography with a view to coronary artery bypass surgery seems desirable in symptomatic patients with familial hypercholesterolaemia because of the common association of this disorder with life-threatening left main-stem disease.
对25例杂合子家族性高胆固醇血症患者和25例以大量吸烟为主要危险因素的冠状动脉疾病正常胆固醇血症患者的冠状动脉疾病范围和严重程度进行了血管造影比较。家族性高胆固醇血症患者比吸烟者年轻，女性比例更高。家族性高胆固醇血症患者中左冠状动脉主干疾病（8例对0例，p<0.05）和三支血管疾病（18例对4例，p<0.05）的发生率明显更高。仅影响远端血管的疾病在5名吸烟者中出现，而所有家族性高胆固醇血症患者均表现为近端和远端病变的组合。这些发现表明，吸烟和家族性高胆固醇血症易导致不同类型的冠状动脉粥样硬化。由于这种疾病与危及生命的左主干疾病常见相关，对于有症状的家族性高胆固醇血症患者，早期进行冠状动脉造影以考虑冠状动脉搭桥手术似乎是可取的。
