他汀药物治疗的冠心病合并严重肾脏病患者基线三酰甘油与长期预后的关系  

Association between baseline triglyceride with long-term prognosis in patients with coronary artery disease and advanced kidney disease after statins treatment

作　　者：王博 李焕强 黄浩樟 陈冠仲 刘历威 刘勇[1] 陈纪言[1] WANG Bo;LI Huan-qiang;HUANG Hao-zhang;CHEN Guan-zhong;LIU Li-wei;LIU Yong;CHEN Ji-yan(Department of Cardiology,Guangdong Provincial Peopled Hospital,Guangzhou 510080,China)

机构地区：[1]广东省人民医院心内科广东省心血管病研究所广东省冠心病预防重点实验室,广东广州510080

出　　处：《中国实用内科杂志》2021年第5期391-395,共5页Chinese Journal of Practical Internal Medicine

基　　金：十三五国家重点研发计划(2017YFC1307600,2017YFC1307603);广东省医学科学技术研究基金项目(B2020204);广东省人民医院(广东省医学科学院)高水平医院“登峰计划”科研专项(DFJH2020026);广东省省级科技计划项目(2017B030314041)。

摘　　要：目的探究接受他汀治疗的冠心病(CAD)合并严重肾脏病[AKD,定义为估计肾小球滤过率<30 mL/(min·1.73m^(2))]患者中基线三酰甘油(TG)水平与长期预后间的关系。方法纳入2008年1月至2018年12月于广东省人民医院住院的接受他汀类药物治疗且CAD合并AKD患者。根据TG浓度是否≥1.7 mmol/L将患者分为2组。使用KaplanMeier方法和Cox回归分析评估TG水平与长期全因死亡率之间的关系。结果共纳入715例符合条件的患者。在2.8年的中位随访期间,共有272例(38.0%)患者死亡。K-M生存曲线发现2组差异无统计学意义。多因素Cox回归分析显示TG水平与长期全因死亡率之间无相关性(HR 1.02,95%CI 0.77~1.35,P=0.89),敏感性分析结果相似。结论CAD和AKD患者接受他汀类药物治疗后,基线TG水平可能与长期预后无关,不需要对该人群TG水平进行严格控制。Objectives To explore the association between triglyceride(TG)with long term prognosis in CAD patients with AKD,who are defined as estimated glomerular filtration rate being less than 30 m L/(min·1.73 m^(2))after treatment of statins.Methods In this observational study,The CAD patients complicated with AKD,estimated glomerular filtration rate<30 m L/(min·1.73 m^(2)),who received statin treatment in Guangdong Provincial Hospital between January 2008 and December 2018.Were included Patients were divided into two groups depending on whether TG concentration≥1.7 mmol/L or not. KaplanMeier method and Cox regression analysis were used to evaluate the association between TG levels and long-term all-cause mortality. Results A total of 715 patients were included. Totally,272(38.0%)patients died during the median follow-up period of 2.8 years. Kaplan-Meier analysis showed no significant difference between two groups. Multivariate Cox regression analysis showed TG was not associated with long-term all-cause mortality(hazard ratio: 1.02,95% confidence interval: 0.77-1.35,P=0.89),and the results of sensitivity analysis were similar. Conclusion Baseline TG levels may not be associated with long-term prognosis for patients suffering from CAD and AKD after treatment of statins,and it may be necessary to be intensively control the TG level in this population.

关 键 词：冠心病 严重肾脏病 三酰甘油 预后 

分 类 号：R54[医药卫生—心血管疾病]