冠心病合并结直肠癌患者血脂水平及他汀类药物调脂的意义  

Significance of blood lipid levels and lipid regulating therapy with statin in patients with coronary heart disease combined with colorectal cancer

作　　者：姜智博 卫晴 JIANG Zhi-bo;WEI Qing(Department of Cardiovascular Medicine ,Tongji University School of Medicine ,Shanghai 200092, China;Department of Cardiovascular Medicine,Shanghai Shen Garden Rehabilitation Hospital, Shanghai 201602, China)

机构地区：[1]同济大学医学院心血管内科,上海200092 [2]上海申园康复医院心血管内科,上海201602

出　　处：《中国肿瘤临床与康复》2018年第6期660-662,共3页Chinese Journal of Clinical Oncology and Rehabilitation

摘　　要：目的探讨冠心病合并结直肠癌患者血脂水平的特点及他汀类药物的调脂作用。方法选取2015年2月至2017年7月间同济大学医学院收治的60例冠心病合并结直肠癌患者为研究组,另选取同期60例单纯冠心病患者为对照组。两组患者均采用冠心病相关常规药物治疗,研究组患者术前口服阿托伐他汀,比较不同时间点两组患者总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)和血浆脂蛋白α[Lp(α)]等血脂相关指标。结果治疗前,研究组患者TC、LDL-C和HDL-C水平均低于对照组,Lp(α)水平高于对照组,差异均有统计学意义(均P<0.05)。两组患者TG水平比较,差异无统计学意义(P>0.05)。对照组患者治疗后和研究组患者手术前TC、TG和LDL-C水平均较之前下降,差异均有统计学意义(均P<0.05);但组间比较,差异无统计学意义(P>0.05)。研究组患者术后6个月TC、TG和LDL-C水平均继续下降,且低于对照组治疗6个月,差异均有统计学意义(均P<0.05)。对照组患者治疗后HDLC水平较前无明显变化(P>0.05)。研究组患者手术前HDL-C水平较之前显著下降,术后6个月有所回升,差异均有统计学意义(均P<0.05)。对照组患者治疗6个月Lp(α)水平较前无明显变化(P>0.05),研究组患者手术前Lp(α)水平较治疗前提高,术后6个月与术前无明显变化,但仍高于治疗前,差异有统计学意义(P<0.05)。结论合并结直肠癌对冠心病患者血脂水平和调脂效果均造成一定影响,他汀类药物对此类患者有一定的调脂作用。Objective To investigate the characteristic of blood lipid levels and the effect of lipid regulating therapy in patients with coronary heart disease combined with colorectal cancer. Methods Sixty patients with coronary heart disease combined with colorectal cancer admitted to Tongji University School of Medicine from February 2015 to July 2017 were selected as the study group. Another 60 patients with single coronary heart disease were selected as the control group. Both groups used the routine agents for coronary heart disease. The study group orally received atorvastatin before the surgery. Total cholesterol（ TC）,triglyceride（ TG）,high-density lipoprotein cholesterol（ HDL-C）,low density lipoprotein cholesterol（ LDLC） and plasma lipoprotein alpha [Lp（ alpha） levels were detected at different time points. Results Before treatment,LDL-C,HDL-C,TC levels were significantly lower in the study group than in the control group and Lp（ alpha） levels were significantly higher in the study group than in the control group（ all P〈 0. 05）. There was no significant difference in TG level between the two groups（ P〉 0. 05）. TC,TG,LDLC levels were decreased significantly in both groups（ P〈 0. 05） but here was no significant difference between the two groups（ P〉 0. 05）. At 6 months TC,TG and LDL-C levels continuously in the study group which was significantly lower than in the control group（ all P〈 0. 05）. There was no significant change in HDL-C in the control group（ P〉 0. 05）. Preoperative HDL-C level was decreased significantly the study group and rised again at 6 months（ all P〈 0. 05）. There was no significant change in Lp（ alpha） in the control group（ P〉 0. 05）. Lp（ alpha） was increased in the study group compared before the treatment. At 6 months,Lp（ alpha） was before the treatment（ P〈 0. 05）. Conclusion The combination of colorectal cancer has a certain effect on blood lipid level and lipid regulating efficacy in patients with

关 键 词：冠状动脉粥样硬化性心脏病 结直肠肿瘤 血脂水平 阿托伐他汀 调脂效果 

分 类 号：R735.3[医药卫生—肿瘤]