主动脉夹层患者血脂水平变化及其与院内死亡的相关性研究  

Relationship Between Blood Lipid Level and In-hospital Death in Patients With Aortic Dissection

作　　者：李文[1] 郭涛[1] 柴湘平[1] 周阳 彭文[1] 彭振宇[1] LI Wen;GUO Tao;CHAI Xiang-ping;ZHOU Yang;PENG Wen;PENG Zhen-yu.(Department of Emergency, The Second Xiangya Hospital of Central South University, Changsha （4 1 0011）, Hunan, China)

机构地区：[1]中南大学湘雅二医院急诊科、中南大学急诊医学及疑难疾病研究所,湖南省长沙市410011

出　　处：《中国循环杂志》2018年第2期157-160,共4页Chinese Circulation Journal

基　　金：国家自然科学基金(81471896)

摘　　要：目的:探讨主动脉夹层患者血脂水平变化及其与院内死亡的相关性。方法:回顾性收集153例主动脉夹层患者临床资料,其中A型主动脉夹层(胸主动脉夹层)患者80例、B型主动脉夹层(腹主动脉夹层)患者73例,并选取体检中心50例单纯高血压患者作为对照,比较主动脉夹层患者与高血压患者、A型主动脉夹层与B型主动脉夹层患者、主动脉夹层患者中存活者与院内死亡者之间的血脂水平,并对主动脉夹层患者存活者与院内死亡者之间有显著差异的血脂指标与院内死亡进行相关性分析。结果:主动脉夹层患者的总胆固醇(TC)水平显著高于单纯高血压患者[3.89(3.19,4.61)mmol/L vs 3.58(2.70,4.33)mmol/L],高密度脂蛋白胆固醇(HDL-C)水平[1.02(0.86,1.25)mmol/L vs 1.52(1.22,1.76)mmol/L]、HDL-C/TC比值[0.28(0.22,0.34)vs 0.45(0.31,0.67)]显著低于单纯高血压患者(P均<0.01);A型主动脉夹层患者的HDL-C/TC比值低于B型主动脉夹层患者[0.27(0.20,0.33)vs 0.30(0.24,0.36),P<0.05];主动脉夹层患者中院内死亡者的HDL-C水平显著低于存活者[0.82(0.69,1.04)mmol/L vs 1.06(0.89,1.33)mmol/L,P<0.01]。Spearman相关分析结果显示,血清HDL-C水平与主动脉夹层患者的院内死亡呈负相关(相关系数=-0.353)。结论:主动脉夹层患者存在明显的血脂代谢异常,血清HDL-C水平与主动脉夹层患者院内死亡呈负相关。Objective： To investigate the relationship between blood lipid level and in-hospital death in patients with aortic dissection（AD）.Methods： Our retrospective study included in 2 groups： AD group, n=153 patients which was further divided into 2 subgroups： Thoracic AD subgroup, n=73 and Abdominal AD subgroup, n=80; Control group, n=50 patients with isolated hypertension at the same period. Blood lipid levels were compared among different groups and subgroups; HDL-C levels were studied by correlation analysis between AD survivor and in-hospital died AD patients.Results： Compared with Control group, AD group had increased TC [3.89（3.19, 4.61） mmol/L] vs [3.58（2.70, 4.33） mmol/L], decreased HDL-C [1.02（0.86, 1.25） mmol/L vs 1.52（1.22, 1.76） mmol/L] and lower ratio of HDL-C/TC [0.28（0.22, 0.34） vs 0.45（0.31, 0.67）], all P〈0.01. Compared with Abdominal AD subgroup, Thoracic AD subgroup had the lower ratio of HDL-C/TC [0.27（0.20, 0.33） vs 0.30（0.24, 0.36）], P〈0.05. Compared with AD survivor, the in-hospital died AD patients had the lower HDL-C level [0.82（0.69, 1.04） mmol/L vs 1.06（0.89, 1.33） mmol/L], P〈0.01. Spearman correlation analysis revealed that HDL-C level was negatively related to in-hospital death of AD（correlation coefficient =-0.353）.Conclusion： AD patients had abnormal lipid metabolism, blood HDL-C level was negatively related to in-hospital death in AD patients.

关 键 词：主动脉夹层 血脂异常 脂蛋白类 高密度脂蛋白 

分 类 号：R54[医药卫生—心血管疾病]