老年代谢异常ASCVD患者风险等级及血脂达标的影响因素  

Influencing factors of risk grade and blood lipid standard-reaching in aged patients with ASCVD complicated abnormal metabolism

作　　者：徐佶佶 高金丽[2] 范虞琪[1] 张俊峰[1] 李振华 黄全 XU Ji-ji;GAO Jin-li;FAN Yu-qi;ZHANG Jun-feng;LI Zhen-hua;HUANG Quan(Department of Cardiology,Ninth Affiliated People's Hospital of School of Medicine,Shanghai Jiaotong University,Shanghai,200011,China)

机构地区：[1]上海交通大学医学院附属第九人民医院心内科,上海200011 [2]上海市宝山区淞南社区卫生服务中心全科 [3]上海市浦东新区祝桥社区卫生服务中心全科

出　　处：《心血管康复医学杂志》2022年第6期666-670,共5页Chinese Journal of Cardiovascular Rehabilitation Medicine

基　　金：上海市中西医学会社区医学与健康管理研究项目(2021-49);上海市宝山区科学技术委员会学卫生项目(21-E-34);上海市宝山区基层卫生品牌培育项目(BSJCPP-A-04)。

摘　　要：目的:分析老年代谢异常动脉粥样硬化性心血管疾病(ASCVD)风险等级及血脂达标的影响因素。方法:依据是否存在代谢异常,16305例60岁以上ASCVD患者被分为代谢异常组(14778例)与代谢正常组(1527例)。比较两组一般临床资料,分析代谢异常因素与ASCVD风险等级的相关性及代谢异常ASCVD高危患者LDL-C水平达标的影响因素。结果:与代谢正常组比较,代谢异常组女性、城市居民比例,年龄、腰围、BMI、收缩压、舒张压、平均动脉压(MAP)、空腹血糖(FBG),总胆固醇、LDL-C、TG水平均显著升高,吸烟比例、HDL-C水平均显著降低(P<0.05或<0.01)。Spearman相关性分析显示,ASCVD危险等级与FBG、TG呈显著正相关(r=0.206~0.365,P均=0.001),与HDL-C、MAP、腰围呈显著负相关(r=-0.051~-0.221,P均=0.001)。多因素Logistic回归分析显示,代谢异常累积个数3、4、5种是代谢异常ASCVD高危患者的独立危险因素(OR=1.686~2.447,P<0.05或<0.01)。结论:血脂、血糖水平等代谢异常是ASCVD的独立危险因素。Objective:To analyze influencing factors of risk grade and blood lipid standard-reaching condition in aged patients with atherosclerotic cardiovascular disease(ASCVD)complicated abnormal metabolism(ABM).Methods:According to suffering from ABM or not,a total of 16305 ASCVD patients>60 years old were divided into ABM group(n=14778)and normal metabolism group(n=1527).General clinical data were compared between two groups,and correlation between ABM factors and ASCVD risk grade and influencing factors of LDL-C level reaching standard in ASCVD high-risk patients with ABM were analyzed.Results:Compared with normal metabolism group,there were significant rise in percentages of female and urban residents,age,waist circumference,BMI,SBP,DBP,mean arterial pressure(MAP),FBG,levels of total cholesterol,LDL-C and TG,and significant reductions in percentage of smoking and HDL-C level in ABM group(P<0.05 or<0.01).Spearman correlation analysis indicated that ASCVD risk grade was significant positively correlated with FBG,TG(r=0.206~0.365,P=0.001 all),and significant negatively correlated with HDL-C,MAP,waist circumference(r=-0.051~-0.221,P=0.001 all).Multivariate Logistic regression analysis indicated that cumulative number of ABM factors 3,4 and 5 were independent risk factors(OR=1.686~2.447,P<0.05 or<0.01).Conclusion:Abnormal metabolism such as lipid and blood glucose levels are independent risk factors for ASCVD.

关 键 词：动脉粥样硬化 代谢综合征X 血脂异常 

分 类 号：R543.509[医药卫生—心血管疾病]