天津医药

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老年冠心病患者血脂代谢特点分析

耿婕1,陈树涛1,王林2   

  1. 1. 天津市胸科医院
    2. 天津医科大学第二医院
  • 收稿日期:2010-08-16 修回日期:2010-11-24 出版日期:2011-03-15 发布日期:2011-03-15
  • 通讯作者: 王林

Analyses of lipid metabolism characteristics in aged patients with coronary heart disease

  • Received:2010-08-16 Revised:2010-11-24 Published:2011-03-15 Online:2011-03-15

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摘要： 目的：探讨老年冠心病患者血脂代谢特点。方法：选择784例65岁以上老年患者，根据冠脉造影结果及有无高血压、糖尿病进行分组，比较各项血脂指标（包括单项血脂和血脂比值）。结果：无论男性和女性，载脂蛋白B（ApoB）、总胆固醇（TC）/高密度脂蛋白（HDL）、低密度脂蛋白（LDL）/HDL水平随冠脉病变的逐渐加重明显升高，而HDL和载脂蛋白A1（ApoA1）/B水平随冠脉病变的逐渐加重明显下降（P<0.05）。高血压组甘油三酯（TG）和 ApoB水平升高，ApoA1/B水平下降（P<0.05）。糖尿病组TG和 TC /HDL水平升高，HDL水平下降（P<0.05）。多元Logistic逐步回归分析表明ApoA1/B是冠心病的独立危险因素。结论：血脂比值对于冠心病的发生及严重程度具有一定的临床预测价值。高血压、糖尿病均影响血脂代谢，治疗老年冠心病人需控制多重危险因素。

关键词: 冠状动脉疾病, 血脂, 老年

Abstract: Abstract Objective: To explore the characteristics of lipid metabolism of aged patients with coronary heart disease(CHD). Methods: According to coronary artery angiography (CAG), 784 subjects aged more than 65 years were divided into four groups. The relationship of individual lipid and lipid ratio with CHD was analyzed. Results: With the increased number of involved branches, apolipoprotein B(Apo B) level, total cholesterol(TC)/high-density lipoprotein (HDL), low -density lipoprotein (LDL) / HDL ratio were gradually increased, the levels of HDL-C and apolipoprotein A1( ApoA1)/ B were gradually decreased(P<0.05), whether male or female. The levels of triglyceride(TG) and Apo B increased, ApoA1/ B decreased in hypertension group(P<0.05). The levels of TG and TC/ HDL increased, HDL decreased in diabetes mellitus group(P<0.05). Multi-Logistic regression analysis showed that ApoA1/ B was an independent risk factor of CHD. Conclusion: Lipid ratio may have clinical forecast value for CHD. Hypertension and diabetes mellitus can affect lipid metabolism, it was important to control the related risk factors in intervention and prevention of aged patients with coronary heart disease.

Key words: coronary disease, lipids, aged