目的 利用64排螺旋CT冠状动脉 造影，探讨高血脂患者合并冠状动脉粥样 硬化所致管腔狭窄程度与范围，分析患者 全套血脂指标(TG、TC、LDL-C、HDL-C)及 PON1活性变化对高血脂并发冠心病的影 响。方法 以接受64排螺旋CT冠状动脉造 影检查的冠心病患者98例为研究对象，其 中合并高血脂50例，无高血脂 48例；观 察并比较两组患者的冠状动脉狭窄的程 度及范围。结果 对照组血清PON1的活性 明显高于高血脂组，差别有显著性意义 (P<0.01)；高血脂患者TC、TG高于对照 组，有显著性差异(P<0.01)。高血脂并发 冠心病组血清PON1活性低于血脂正常无 并发症组(P<0.01)；高血脂并发冠心病 组的TC、LDL高于无并发症组(P<0.05)。 相关性分析：PON1活性与TC、LDL呈负相 关(P<0.01)；PON1活性与HDL呈正相关 (P<0.05)。结论 64排螺旋CT冠状动脉造 影能够准确反映冠状动脉狭窄程度、范围 与高血脂患者与正常血脂之间的差异，结 合患者血清中HDL-C及PON1活性水平，可 作为冠心病患者危险分层的一个指标，对 早期判断冠状动脉狭窄程度，为临床冠心 病开展综合性、无创性诊疗方法提供合理 的依据。

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.