中国血脂异常门诊患者FH的横断面调查:DYSIS-China研究分析

来源 :中华心血管病杂志 | 被引量 : 0次 | 上传用户:blackfairy
下载到本地 , 更方便阅读
声明 : 本文档内容版权归属内容提供方 , 如果您对本文有版权争议 , 可与客服联系进行内容授权或下架
论文部分内容阅读
目的:分析国际血脂异常调查-中国研究(DYSIS-China)数据库中家族性高胆固醇血症(FH)的发病现状、血脂状况及心血管疾病发病情况。方法:选取2012年3—10月DYSIS-China数据库中,年龄≥45岁、至少接受1种降脂药物治疗3个月的血脂异常患者。根据荷兰脂质临床监测指南(DLCN)中FH的诊断标准,将患者分为不太可能FH组、可能FH组、确诊/极可能FH组。收集并比较3组患者的年龄、性别、血脂水平、用药情况及合并症等基本临床资料,并对可能FH组和确诊/极可能FH组按年龄进行分层比较。结果:共纳入23 973例血脂异常的患者,年龄(64.8±9.9)岁,女性11 757例(49.0%),不太可能FH组20 561例(85.7%),可能FH组3 294例(13.7%),确诊/极可能FH组118例(0.5%)。确诊/极可能FH组年龄(58.4±8.5)岁,低于不太可能FH组(65.3±9.8)岁和可能FH组(61.8±9.9)岁;低密度脂蛋白胆固醇(5.6±1.9)mmol/L,高于不太可能FH组(2.5±0.9)mmol/L和可能FH组(4.3±1.0)mmol/L,总胆固醇(7.4±1.8)mmol/L,高于不太可能FH组(4.3±1.0)mmol/L和可能FH组(6.0±1.0)mmol/L;女性、久坐生活方式比例及收缩压高于其他两组(n P均<0.05)。3组间服用他汀剂量的差异无统计学意义。确诊/极可能FH组缺血性心脏病为70例(59.3%),与不太可能FH组7 519例(36.6%)和可能FH组1 149例(34.9%)相比较高;高血压82例(69.5%),高于可能FH组2 063例(62.6%)和不太可能FH组13 928例(67.7%)。可能FH组55~64岁年龄段比例最高,为1 146例(34.8%),≥75岁组高血压358例(76.8%)、糖尿病189例(40.6%)、缺血性心脏病186例(39.9%)、脑血管疾病149例(32.0%)及心力衰竭28例(6.0%)患病率最高(n P均<0.05)。确诊/极可能FH组55~64岁年龄段比例最高,为49例(41.52%),45~54岁组缺血性心脏病患病率最高,为70例(59.3%)(n P均<0.05),糖尿病、高血压、心力衰竭、外周动脉疾病及脑血管疾病患病情况在各年龄组中差异无统计学意义。n 结论:中国血脂异常患者的FH检出率并不低,但血脂水平控制不佳,心血管疾病发病风险较高。“,”Objectives:To analyze the incidence, blood lipid levels and cardiovascular disease of familial hypercholesterolemia (FH) in dyslipidemia patients receiving lipid-lowing therapy from the DYSIS-China.Methods:Dyslipidemia International Study-China (DYSIS-China) database was re-analyzed according to the criteria of “Chinese guidelines for prevention and treatment of dyslipidemia in adults-2016 version”. DYSIS-China database included 25 317 dyslipidemia out-patients who received at least one lipid-lowering drug for at least three months. All the patients were divided into three groups: unlikely HFn , possible FH and definite FH according to the Dutch Lipid Clinic Network diagnostic criteria. Age, gendern , lipids levelsn , drug use and complications were compared among the three groups. Factors were compared between Possible FH group and definite FH group in terms of age stratification.n Results:A total of 23 973 patients with dyslipidemia were included. The average age was (64.8±9.9) yearsn , 11 757 patients were females (49.0%). The proportion of unlikely FH in the total population was 20 561 (85.7%)n , possible FH was 3294 (13.7%)n , and the definite FH was 118(0.5%). Patients in the definite FH group (58.3±8.5 years) was younger than in unlikely HF(65.3±9.8 years) and possible FH(61.8±9.9 years) group. LDL-C ((5.6±1.9) mmol/L) levels were significantly higher in definite FH group than in unlikely HF ((2.5±0.9) mmol/L) and possible FH ((4.3±1.0) mmol/L) group. TC ((7.4±1.8) mmol/L) levels were also significantly higher in definite FH group than in unlikely HF ((4.3±1.0) mmol/L) and possible FH ((6.0±1.0) mmol/L) group. Percent of female sex, sedentary lifestyle and systolic blood pressure value were significantly higher in definite FH group than in other two groups (all n P<0.05). Statin use was similar among the 3 groups. Prevalence of ischemic cardiomyopathy (70(59.3%)) was significantly higher in the definite FH group than in unlikely FH group7519 (36.6%) and possible FH group1149 (34.9%). The rate of hypertension (82 (69.5%)) was also significantly higher in the definite FH group than in unlikely FH group (2 063 (62.6%) and in possible FH group (13 928 (67.7%)). The possible FH group had the highest proportion of patients aged 55-64 years (1 146 (34.8%)), and the prevalence of hypertension 358 (76.8%), diabetes 189 (40.6%), ischemic heart disease 186 (39.9%), cerebrovascular disease 149 (32.0%) and heart failure 28 (6.0%) was the highest in patients over 75 years old. The definite FH group had the highest proportion of patients aged 55-64 years (49 (41.52%)), and the prevalence of ischemic heart disease (70 (59.3%)) was the highest in patients aged 45-54 years old group, there was no significant difference in the prevalence of diabetes,hypertension,heart failure,peripheral artery disease and cerebrovascular disease among different age groups.n Conclusion:The detection rate of FH in Chinese patients with dyslipidemia is not lown , the blood lipid level is poorly controlledn , and the risk of cardiovascular disease is high in Chinses FH patients.n
其他文献
早产儿视网膜病变(ROP)是一种增生性血管性视网膜疾病,冷冻治疗、激光光凝治疗、玻璃体腔注射抗血管内皮生长因子(VEGF)药物治疗、巩膜扣带手术和玻璃体切割手术等是其主要治疗手
目的探讨广东地区呼吸道过敏性疾病患儿过敏原致敏情况,为该地区过敏性疾病预防和治疗提供依据。方法回顾性收集2019年8月至2020年8月就诊于广州医科大学附属第一医院和中山市博爱医院儿科门诊,确诊为过敏性鼻炎和(或)哮喘,并经ImmunoCAP 1000(荧光酶联免疫分析法)或皮肤点刺试验检测表现为至少一种过敏原阳性的患儿血清样本254例,其中男173例,女81例,年龄中位数(四分位间距)为7(4.
报告1例Ⅰ型神经纤维瘤病合并肝脏原发神经内分泌肿瘤的病例。患者男,47岁,Ⅰ型神经纤维瘤病病史20余年。患者两年前意外发现肝脏占位,随访期间,肿块逐渐增大。CT检查为肝Ⅳ、Ⅷ段低密度肿块;MRI呈稍长T1不均匀长T2信号,增强扫描均呈渐进性持续明显强化;最终病理确诊为肝脏神经内分泌肿瘤。
目的初步探讨视网膜母细胞瘤(RB)因误诊行玻璃体切割手术(PPV)治疗后临床处理方法。方法回顾性病例研究。2015年7月至2018年7月于北京同仁医院眼科中心病理检查确诊的RB患儿5例5只眼纳入研究。其中,男性3例3只眼,女性2例2只眼;均为单眼患病。平均年龄(4.8±1.7)岁。首次就诊诊断为眼内炎2只眼(40%,2/5);玻璃体积血3只眼(60%,3/5)。均行PPV治疗。患儿均行裂隙灯显微镜
目的观察并初步探讨重度子痫前期(S-PE)患者合并渗出性视网膜脱离的影响因素及对妊娠结局的影响。方法2018年7月至2020年6月于天津市第三中心医院产科确诊为S-PE的89例患者纳入研究。根据是否合并渗出性视网膜脱离,将其分为网脱组、非网脱组,分别为43、46例。患者均行直接检眼镜检查,疑似及明确视网膜脱离者行光相干断层扫描或眼B型超声检查。收集患者年龄、病程、体重指数、收缩压、舒张压以及实验室
目的探讨应用心脏磁共振(CMR)组织追踪技术定量评估冠状动脉慢性完全闭塞性病变(CTO)患者左心室心肌应变的临床应用价值。方法该研究为回顾性、观察性研究。入选2014年11月至2019年1月在北京安贞医院行CMR检查的单支CTO患者作为病例组(即CTO组),另选取同期经超声心动图、心电图和临床病史等排除的无心血管疾病且CMR无异常表现的人群作为健康对照组(即对照组)。通过电子病历系统提取入选者的年
目的花粉过敏所致的季节性变应性鼻炎(AR)患者在花粉季前接受预防性治疗可减轻花粉季期间症状。本研究拟评价预防性使用甲磺司特对于AR患者花粉季中生活质量的影响,并应用转录组学方法探讨其预防作用机制。方法这是一项随机对照研究。于2020年1至6月在北京协和医院变态反应科门诊招募对杂草花粉过敏的AR患者,将患者分为两组,预防组在花粉播散前2周开始服用甲磺司特预防治疗[10例,男性4例、女性6例,年龄(3
恶性胸膜间皮瘤(MPM)是一种罕见的、具有高度侵袭性的、来源于间叶组织的肿瘤。目前应用化疗及免疫治疗方法对MPM的疗效欠佳,探寻能够有效且准确地指导治疗及预测预后的免疫标志物,挖掘潜在免疫治疗新靶点已成为MPM治疗研究领域的热点之一。近年研究发现,MPM具有抑制性肿瘤免疫微环境。肿瘤浸润淋巴细胞(TIL)作为肿瘤免疫微环境中重要组分,也参与了机体免疫调控。但目前关于TIL对MPM治疗效果及预后影响
期刊
甲状腺自身免疫以甲状腺自身抗体阳性为特征,是育龄女性常见疾病。近年来,有关甲状腺自身免疫与妊娠结局的研究结果具有争议。为此,本文就甲状腺自身免疫对女性生殖系统的病理生理、不良妊娠结局、辅助生殖结局的影响以及补充左甲状腺素是否能够改善甲状腺自身免疫的不孕症妇女妊娠结局的相关研究进行综述。