| 摘要: |
| 目的 探讨低密度脂蛋白胆固醇（LDL-C）水平正常的老年人颈动脉粥样硬化斑块的形成及稳定分型与甘油三酯（TG）/高密度脂蛋白胆固醇（HDL-C）比值、小而密低密度脂蛋白胆固醇（sdLDL-C）的相关性。方法 回顾分析 2021年5月至 2022年5月来我院就诊的年龄≥65岁、LDL-C＜3.40 mmol/L老年人群的临床资料，收集其一般资料及血清学数据。根据有无颈动脉斑块将患者分为无斑块组（57例）和斑块组（131例），再根据超声超微血管成像（SMI）检查结果，进一步将斑块组分为新生血管组（即不稳定斑块组，77例）和无新生血管组（即稳定斑块组，54例）。对斑块内新生血管进行SMI分级，分析颈动脉粥样硬化斑块形成和斑块内新生血管形成的血清学危险因素。结果TG/HDL-C比值和HDL-C、sdLDL-C水平在无斑块组、无新生血管组、新生血管组间差异均有统计学意义（P均＜0.05）。斑块组SMI 0级、SMI 1级、SMI 2级患者的斑块厚度、sdLDL-C水平依次升高，在3个SMI分级间的差异均有统计学意义（P均＜0.01）。使用Spearman秩相关分析得出LDL-C水平正常的老年人颈动脉斑块SMI分级与斑块厚度、sdLDL-C水平之间均呈正相关（r＝0.758，P＜0.01；r＝0.676，P＜0.05）。将斑块厚度、sdLDL-C、HDL-C、TG/HDL-C比值作为自变量，将斑块SMI分级作为因变量进行线性回归分析，结果 显示斑块厚度和sdLDL-C是斑块SMI分级的危险因素（b＝0.779，P＜0.001；b＝0.436，P＜0.05）。结论 HDL-C、TG/HDL-C比值、sdLDL-C与LDL-C水平正常的老年人颈动脉斑块的形成有关。斑块厚度、sdLDL-C水平是影响斑块内新生血管形成和斑块稳定性的危险因素。 |
| 关键词: 动脉硬化斑块 老年人 甘油三酯 高密度脂蛋白 高密度脂蛋白胆固醇 小而密低密度脂蛋白 |
| DOI：10.16781/j.CN31-2187/R.20220873 |
| 投稿时间：2022-11-13修订日期：2023-04-25 |
| 基金项目:黑龙江省中医药管理局科研项目(ZHY2020-110,ZHY2020-114). |
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| Correlations of carotid atherosclerotic plaque formation and its stable classification with TG/HDL-C ratio and sdLDL-C in elderly people with normal LDL-C level |
| ZHAO Lina,SHI Guangyu,GUO Zhe,XUE Xiaorui,SUN Xiaowei,LI Yaxue,ZHANG Xuesong* |
(Department of Ultrasound, The First Affiliated Hospital, Heilongjiang University of Traditional Chinese Medicine, Harbin 150040, Heilongjiang, China
*Corresponding author) |
| Abstract: |
| Objective To investigate the correlations of the formation and stable classification of carotid atherosclerotic plaque with triglyceride (TG)/high-density lipoprotein cholesterol (HDL-C) ratio and small and dense low-density lipoprotein cholesterol (sdLDL-C) in the elderly people with normal low-density lipoprotein cholesterol (LDL-C) level. Methods General and serological data of the elderly people with age≥65 years old and LDL-C＜3.40 mmol/L, who came to our hospital from May 2021 to May 2022, were retrospectively analyzed. According to the presence or absence of carotid plaque, the patients were divided into non-plaque group (57 cases) and plaque group (131 cases). According to the results of ultrasonic superb micro-vascular imaging (SMI), the plaque group was further divided into neovascularization group (unstable plaque group, 77 cases) and non-neovascularization group (stable plaque group, 54 cases). To further analyze the serological risk factors of carotid atherosclerotic plaque formation and neovascularization in plaque, SMI grading was conducted for neovascularization in plaque. Results TG/HDL-C ratio and HDL-C and sdLDL-C levels were significantly different among the non-plaque group, neovascularization group and non-neovascularization group (all P＜0.05). In the plaque group, the plaque thickness and sdLDL-C level of patients with SMI grade 0, SMI grade 1 and SMI grade 2 increased in turn, and the differences among the 3 SMI grades were statistically significant (both P＜0.01). Spearman rank correlation analysis showed positive correlations of SMI grade of carotid plaque with plaque thickness and sdLDL-C level in the elderly people with normal LDL-C level (r＝0.758, P＜0.01; r＝0.676, P＜0.05). When the plaque thickness, sdLDL-C, HDL-C and TG/HDL-C ratio were used as independent variables and the plaque SMI grade was used as a dependent variable for linear regression analysis, the results showed that plaque thickness and sdLDL-C were risk factors for plaque SMI grade (b＝0.779, P＜0.001; b＝0.436, P＜0.05). Conclusion HDL-C, TG/HDL-C ratio and sdLDL-C are related to the formation of carotid plaque in the elderly people with normal LDL-C level. Plaque thickness and sdLDL-C level are risk factors for neovascularization and plaque stability. |
| Key words: atherosclerotic plaque the aged triglyceride high-density lipoprotein high-density lipoprotein cholesterol small and dense low-density lipoprotein |
