老年男性冠心病患者血清总胆固醇水平与冠心病死亡的11年随访研究  

Association of serum total cholesterol with mortality from coronary heart disease in the male elderly with coronary artery disease

作　　者：刘剑锋[1] 朱平[1] 李小鹰[1] 张丽[1] 司全金[1] 蔡兰萍[1] 樊瑾[1] 王曙霞[1] 王海军[1] 

机构地区：[1]解放军总医院,北京100853

出　　处：《中华老年心脑血管病杂志》2008年第4期266-269,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

摘　　要：目的探讨老年男性冠心病患者血清TC水平与冠心病死亡的关系。方法采用回顾性队列研究方法,将878例年龄≥65岁的老年男性冠心病患者按TC水平分为4组:1组(158例):TC<4.16mmol/L、2组(182例):4.16mmol/L≤TC<4.68mmol/L、3组(205例):4.68mmol/L≤TC<5.2mmol/L、4组(333例):TC≥5.2mmol/L,应用COX比例风险模型进行11年生存分析。结果与2组患者比较,校正前,1组和4组冠心病死亡的发病风险分别增加了131%(P=0.034)、28%(P=0.039),TC与冠心病死亡呈U型关系;校正传统危险因素后,1组患者的冠心病死亡风险增加了271%(P=0.028),TC浓度与冠心病死亡风险呈"L"型关系。结论在老年男性冠心病患者中,TC过低能明显增加冠心病病死率。Objective To evaluate the association between serum total cholesterol（TC） and mortality from all-causes and coronary heart disease（CHD） in the male elderly with CHD. Methods In this retrospective cohort study, 878 subjects aged over 65years with CHD were recruited from 1996 to 2007 in Chinese PLA General Hospital. According to their TC level,the patients were di vided into 4 groups：groupl（TC〈4.16 mmol/L）,group2（4.16 mmol/L≤TC〈4.68 mmol/L）, group3（4.68 mmol/L≤TC〈5.2 mmol/L）,group4（TC≥5.2 mmol/L）. The association between baseline serum TC level and CHD death was analyzed using Cox muhivariate proportional hazards regression. Results Compared with group2,before adjustment,the risk of CHD death in groupsl and 4 increased by 131% and 28% respectively. The relationship between TC level and CHD death was U type. After adjustment for conventional risk factors,the CHD death RR increased by 271% （ P = 0. 028）, the relationship between TC level and CHD death was L type. Conclusion In senile male CHD population,TC level that is too low can increase the mortality of CHD. The a bove results showed that lowering lipid is beneficial.

关 键 词：冠状动脉疾病 胆固醇 死亡率 危险因素 随访研究 

分 类 号：R541.4[医药卫生—心血管疾病]