| Objective:Through comparison small density lipoprotein cholesterol(sdldl-c),triglyceride(TG)and other commonly used blood lipid indexes and the results of coronary angiography(CAG)were examined in patients with CHD after PCI at intervals of 6 months or more,the relationship between the progress of non-culprit coronary lesions(NCCLs)and common blood lipid indexes such as sdLDL-C and TG in CHD patients after PCI was analyzed.Exploring the predictive value of NCCLs in CHD patients after PCI,and provide a theoretical basis for improving the prognosis of CHD patients.Methods:A total of 130 patients who underwent PCI in the Second Hospital of Shanxi Medical University from September 2017 to December 2019 and underwent CAG reexamination at intervals of 6 months or more were selected.The basic clinical data such as age,sex,smoking and drinking history,hypertension history,diabetes history,hyperlipidemia history,time of first PCI,time of CAG reexamination,and serum sdLDL-C,TG levels were collected and entered into the database.According to the results of CAG reexamination and combined with the pathological conditions of NCCLs after PCI,the enrolled patients were divided into progressive group and non-progressive group.The general clinical data and serum sdLDL-C and TG levels of the two groups of patients were analyzed and compared.According to the degree of NCCLs,the lesion progression group was divided into mild progression group,moderate progression group and severe progression group.The serum levels of sdLDL-C,TG and other blood lipid indicators were further analyzed and compared in each subgroup,and the relevant factors and the degree of NCCLs lesion progression were analyzed by logistic regression.Results:1.General information of subjects: According to inclusion criteria and exclusion criteria,130 cases were included in the study.The average age of the selected patients was 57.58±8.13 years old,including 96 males(73.8%)and 34 females(26.2%).According to the diagnostic criteria and related medical history,62 cases(47.7%)of smokers,47 cases(36.2%)of alcohol drinking,28 cases(21.5%)with diabetes,77 cases(59.2%)with hypertension,58 cases(44.6%)with hyperlipidemia,24 cases(18.5%)with family history.2.Comparison of clinical data between progression group and non progression group: There were no significant differences between the progressive group(52 cases,40.0%)and the non-progressive group(78cases,60.0%)in age,sex,smoking,drinking,diabetes,hypertension,family history,etc.(P>0.05).3.Changes of serum sdLDL-C and TG levels in progressive and non-progressive groups: The serum levels of sdLDL-C,TG and Lp(a)in the progression group were significantly higher than those in the non-progression group(P<0.05),while the serum levels of HDL-C were significantly lower than those in the non-progression group(P<0.05).4.Changes of serum sdLDL-C and TG levels among subgroups in lesion progression group: The serum levels of sdLDL-C,TG and Lp(a)in mild,moderate and severe progression groups were higher than those in non-progression group,while the serum levels of HDL-C were lower than those in non-progression group,and there were significant differences(P<0.05).The serum levels of sdLDL-C,TG and Lp(a)gradually increased,while the serum levels of HDL-C gradually decreased with the increase of lesion severity,and there were significant differences among the subgroups(P<0.05).5.Logistic regression analysis of NCCLs disease progression: Serum sdLDL-C,TG and HDL-C were the independent risk factors of NCCLS in CHD patients.The OR values of serum sdLDL-C,TG and HDL-C were 9.473,10.070 and 13.251,respectively.Conclusion:1.The rate of LDL-C reaching the standard after PCI in CHD patients was 88.46%,and the rate of NCCLs lesion progression was 40%,suggesting that attention should be paid to the level of sdLDL-C,the strongest AS-causing subtype of LDL-C,while the risk factors other than blood lipids should be strictly controlled.2.The higher the levels of serum sdLDL-C,TG and LP(a),the lower the level of HDL-C,the more obvious the progression of NCCLs.It is suggested that there are many kinds of lipid disorders in CHD patients after PCI.It is very important to strengthen the monitoring of lipid profile and explore more effective treatment.3.Serum sdLDL-C and TG in CHD patients after PCI may be independent risk factors for predicting the progression of NCCLs.We should pay attention to the changes of serum sdLDL-C and TG,which has a certain clinical significance to evaluate the risk of the progression of NCCLs. |
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