急性心肌梗死患者血脂改变及其对预后的影响分析  

Change of blood lipids in acute myocardial infarctionand its influence on prognosis

作　　者：彭云珠[1] 郭涛[1] 郑圆圆[2] 杨萍[3] 华宝桐[1] 潘家华[1] 赵玲[1] 

机构地区：[1]昆明医学院第一附属医院心内科,650031 [2]昆明医学院第一附属医院呼吸内科,650031 [3]昆明市第一人民医院心内科,650011

出　　处：《重庆医学》2012年第16期1601-1603,共3页Chongqing medicine

基　　金：云南省卫生科技计划项目(2010NS018);云南省卫生科技计划项目(2010NS017)

摘　　要：目的了解冠心病急性心肌梗死(AMI)患者血脂改变情况及其对预后的影响分析。方法采用随机抽样调查住院病历资料的方式,研究206例发生AMI的冠心病患者(AMI组)和240例未发生AMI的冠心病患者(对照组)的部分血液生化指标、住院期间不良事件发生情况等;并对部分AMI组患者进行回访调查。结果 AMI组患者血清三酰甘油酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)水平均明显低于对照组(P<0.05),高密度脂蛋白胆固醇(HDL-C)水平在两组间比较,差异无统计学意义(P>0.05)。多因素回归分析显示AMI患者住院期间发生的不良事件概率与年龄、HDL-C两种因素有关(P<0.05),其中与年龄呈正相关关系(回归系数为1.922),与HDL-C水平呈负相关关系(回归系数为―1.401)。多因素回归分析显示成功回访的112例AMI患者1年内发生不良事件概率与年龄和住院期间LDL-C水平有关(P<0.05),与住院期间LDL-C水平呈负相关关系(回归系数为―0.287),与年龄呈正相关关系(回归系数为0.672)。结论发生AMI的冠心病患者血脂水平较未发生AMI患者低,AMI患者住院期间及1年内发生不良事件的概率与血脂水平、年龄等因素有关。Objective To study the changes of blood lipids such as triglyceride（TG）, total cholesterol（TC）, high density lipo- protein cholesterol（H-DLC） and low density lipoprotein cholesterol（LDL-C） in the patients with acute myocardial infarction（AMI） and its significance in prognosis. Methods By random sampling survey on the clinical data of 206 cases of coronary heart disease （CHD） with AMI（ as the AMI group） and 240 CHD patients without AMI （as the control group）, this study researched the par- tial lipid indexes and the adverse events in hospitalization duration. Partial patients in the AMI group were performed the follow up survey. Results The levels of TG, TC, LDL-C in the AMI group were significantly lower than those in the control group（P〈0. 05）. The level of HDL-C had no statistical difference between the two groups（P〉0.05）. Multivariate Logistic regression analysis showed that the probability of adverse events occurrence during hospitalization in the AMI patients was related with the age and HDL C（P〈0.05）, among them, which was positively correlated with the age （regression coefficien t=l. 9221 and negatively core- lated with the level of HDL-C （regression coefficien t=l. 401）. Multivariate Logistic regression analysis showed that the proba- bility of adverse events occurrence within 1 year in 112 AMI patients with successful follw up was related with age and the level of LDL-C during hospitalization（P〈0, 05） ,among them, which was negatively correlated with the LDL-C level during hospitalization （regression coefficient=-0. 287） and positively correlated with the age （regression coefficien t=-0. 672）. Conclusion The levels of blood lipids in CHD patients with AMI are lower than those in CHD patients without AML The probability of adverse events ocurrence during hospitalization and within 1 year is associated with the age and the level of blood lipids.

关 键 词：心肌梗死 甘油三脂类 胆固醇 脂蛋白类 预后 

分 类 号：R542.22[医药卫生—心血管疾病]