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頁籤選單縮合
題名 | 國人之血脂異常與冠狀動脈疾病的關係=Dyslipoproteinemias in Taiwanese Patients with Coronary Artery Disease |
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作者 | 黎新彬; 李啟明; 簡國龍; 許秀卿; 黃玉真; 李源德; | 書刊名 | 內科學誌 |
卷期 | 8:1 1997.03[民86.03] |
頁次 | 頁12-17 |
分類號 | 415.38 |
關鍵詞 | 血中脂質; 冠狀動脈疾病; Serum lipid; Coronary artery disease; |
語文 | 中文(Chinese) |
中文摘要 | 血脂異常是冠狀動脈疾病的主要因子。本文旨在探討國人冠狀 動脈疾病與血脂異常的關係。針對168位因胸痛而住院接受冠狀動脈攝影 之病人,其中107名有顯著冠狀動脈病歸類為疾病組,而61名無顯著冠狀 動脈病歸類為非疾病組藉以對照。所有患者在隔夜空腹14小時後抽取靜脈 血,測定血中脂質,包括全血膽固醇(Total Chol-esterol,TC),三酸 甘油脂(Triglyceride,TG),高密度脂蛋白膽固醇(High Density Lipoprotein-Cholesterol,HDL-C),低密度脂蛋白膽固醇(Low Density Lipoprotein-Cholesterol,LDL-C),原脂蛋白 A1(Apolipoprotein Al,Apo Al),原脂蛋白B (Apolipoprotein B, Apo B) 和 (a)型脂蛋白 〔Lipoprotein (a),Lp(a)〕等七項。冠狀 動脈疾病 (Coronary Artery Disease,CAD) 係以冠狀動脈攝影確定 阻塞部份達50%以上時為界定標準,結果顯示在CAD患者中所具有的冠狀 動脈疾病的危險因子(包括年齡、男性、高血壓、糖尿病、抽煙和冠狀動脈 疾病的家族史)及各種血中脂質異常的比率都高於非疾病組,但血脂異常的 比率只有高密度脂蛋白和原脂蛋白 B 達到統計學上顯著的差異 (p<0.001) 。如以各種血中脂質發生異常的數目來看,具有五項以上血脂 異常的病人都是CAD 的患者;分別有四項以上、三項及二項血脂異常的病 人其發生CAD的勝算比分別15.0、4.5和3.5;具有一項的血脂異常者其 發生CAD的勝算比亦有2.3(95%可信度0.96 -5.5),有臨界統計顯著性。 血脂異常的數目對病人是否罹患冠狀動脈疾病是主要指標,血脂異常數目愈 多,病人罹患冠狀動脈疾病比例愈高,有劑量效應。 ,血脂異常數目愈多,病人罹患冠狀動脈疾病比例愈高,有劑量效應。 |
英文摘要 | Dyslipoproteinemia has been known as critical fctors associated with coronary artery disease (CAD). This study was to investigate whether individuals diagnosed with angiography as CAD patients were at greater risk of being dyslipoproteinemia compared with those defined as non-CAD. In a cross-sectional design, 14-hour overnight fast lipid levels were measured and angiography was performed for 168 patients soon after being hospitalized. Of them, 107 individuals were found with stenosis in coronary tree for 50% or above based on angiography and defined as CAD patients, and the rest of 61 individuals were non-CAD patients. CAD patients were more likely than non-CAD patients to be older, male, hypertension, diabetic, and smoking and to have family CAD history. The following serum lipids were determined: total cholesterol (TC), triglyceride (TG) , high density liporoteincholesterol (HDL-C) , low density lipoprotein-cholesterol (LDL-C), apolipoprotein Al (Apo Al), apolipoprotein B (Apo B) and lipoprotein (a) [Lp (a)]. Average levels of all these lipids were higher in CAD patients than in non-CAD patients. The differences for HDL-C and Apo B were significant at 0.001 level. If we define TC ≧ 240mg/dl, TG ≧ 250mg/dl, LDL-C ≧ 160mg/dl, HDL-C<35mg/dl, Apo Al<90mg/dl, Apo B > 80mg/dl and Lp (a) > 20mg/dl as cut off levels of lipidemia, individuals with five or above items at abnormal levels in this study were exclusively the CAD patients identified from the angiography. Analysis indicated that carrying one dyslipoprotienemia item increased the risk of CAD by 130% [odds ratio (OR)=2.3,95% confidence interval 0.96-5.5]. Carrying two, three, and four or above abnormal items would, respectively, elevated the odds of CAD to 3.5, 4.5, 15.0; a dose-response pattern existed. The authors conclude that individuals with more lipid items at abnormal levels were at the greater odds to be associated with CAD. |
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