Objective Using 64 row spiral CT coronary angiography, on patients with hyperlipidemia combined degree of luminal stenosis caused by coronary atherosclerosis and scope, analysis of patients with a full range of blood fat index (TG, TC, LDL, HDLC-C) content and activity of PON1 change effect on hyperlipidemia and coronary heart disease. Methods There were 98 cases of coronary heart disease with coronary angiography of 64 spiral CT coronary angiography, with 50 cases of hyperlipidemia and 48 cases without hyperlipidemia. To observe and compare the degree and extent of coronary artery stenosis in two groups. Results The activity of serum PON1 in the control group was significantly higher than that in hyperlipidemia, and the difference was significant (P<0.01). TG and TG were higher than the control group, with significant difference (P<0.01). The serum PON1 activity was lower than the normal group (P<0.01). The TC and LDL of the CHD group with hyperlipidemia were higher than those of no complications (P<0.05). Correlation analysis: the activity of PON1 was negatively correlated with TC and LDL (P<0.01). The activity of PON1 was positively correlated with HDL (P<0.05). Conclusion 64 row spiral CT coronary angiography can accurately reflect the degree of coronary artery stenosis, scope and the difference between hyperlipidemia patients with normal blood lipid, combined with patient serum HDL - C and PON1 activity level, can be used as a index, the risk stratification of patients with coronary heart disease for early judgment of coronary artery stenosis degree, and comprehensive, non-invasive diagnostic method for clinical coronary heart disease (CHD) to provide a reasonable basis.