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目的:对比研究不同年龄急性冠脉综合征患者急性期血脂代谢特点及相关因素变化,探讨血脂代谢在不同年龄急性冠脉综合征发生过程中的作用及临床意义。方法:222例急性冠脉综合征(ACS)患者及119例稳定型心绞痛(SAP)患者共341例按照年龄分为3组,<60岁为非老年组共68人,其中ACS组33人,SAP组35人;60-74岁为普通老年组共67人,其中ACS组34人,SAP组33人;≥75岁为高龄老年组共206人,其中ACS组155人,SAP组51人。详细记录其基线资料并测定其血脂各项指标(包括TC、TG、LDL-C、HDL-C)及CRP。结果:与SAP患者比较,非老年人组及普通老年人组ACS患者LDL-C、CRP均显著升高;高龄老年人ACS患者LDL-C水平无显著升高,但HDL-C显著降低,CRP显著升高,差异均具有统计学意义(P<0.05),LDL-C虽无显著升高,但未达指南要求水平。各组之间TC、TG之间差异无统计学意义(P>0.05)。结论:脂代谢异常在不同年龄ACS患者的发生过程中均有重要作用,老年ACS患者中,除了应关注脂代谢紊乱外,还应该关注高血压、糖尿病等危险因素。
Objective: To compare the changes of blood lipid metabolism and related factors in acute coronary syndrome patients of different ages, and to explore the role and clinical significance of blood lipid metabolism in the pathogenesis of acute coronary syndromes of different ages. Methods: A total of 341 patients with 222 patients with acute coronary syndrome (ACS) and 119 patients with stable angina pectoris (SAP) were divided into 3 groups according to their age. Among them, 68 were non-elderly group, 35 in the SAP group and 67 in the 60-74 age group, of whom 34 in the ACS group and 33 in the SAP group; and 206 in the elderly group of ≥75 years, including 155 in the ACS group and 51 in the SAP group. The baseline data were recorded in detail and their blood lipids were measured (including TC, TG, LDL-C, HDL-C) and CRP. Results: Compared with patients with SAP, LDL-C and CRP were significantly increased in non-elderly patients and elderly patients with ACS; LDL-C was not significantly increased in elderly ACS patients, but HDL-C was significantly decreased, while CRP (P <0.05). Although LDL-C did not increase significantly, it was lower than the guideline level. There was no significant difference between TC and TG in each group (P> 0.05). CONCLUSION: Abnormal lipid metabolism plays an important role in the pathogenesis of ACS patients of different ages. In elderly patients with ACS, the risk factors of hypertension and diabetes mellitus should be considered in addition to the disturbance of lipid metabolism.