小而密低密度脂蛋白胆固醇水平与冠心病合并2型糖尿病患者再发心血管事件的相关性分析  

Correlation analysis between small and dense low-density lipoprotein cholesterol levels and recurrence of cardiovascular events in patients with coronary heart disease and type 2 diabetes

作　　者：张海姣 董静[1] 祝万洁 司元元 魏戬 ZHANG Hai-jiao;DONG Jing;ZHU Wan-jie;SI Yuan-yuan;WEI Jian(Department of Cardiology,the Second Affiliated Hospital of Zhengzhou University,Zhengzhou 450014,China)

机构地区：[1]郑州大学第二附属医院心内科,河南省郑州市450014

出　　处：《中国心血管病研究》2023年第6期532-537,共6页Chinese Journal of Cardiovascular Research

基　　金：河南省科技攻关项目(LHGJ20220438)。

摘　　要：目的 研究冠心病合并2型糖尿病患者再发心血管事件与其血清小而密低密度脂蛋白胆固醇(sdLDL-C)水平的相关性。方法 选取2020年3月至2021年3月于郑州大学第二附属医院心内科接受造影检查的冠心病患者188例,其中合并2型糖尿病患者(n=112)为实验组,不合并2型糖尿病患者(n=76)为对照组。检测受试者血清sdLDL-C等实验室指标,并根据sdLDL-C水平最佳截断点将对照组及实验组患者分为对照低值组(n=42)、对照高值组(n=34)、实验低值组(n=58)、实验高值组(n=54)。对上述患者均进行1年的随访,记录并比较各组患者的一般资料以及在1年内心血管事件再发情况,分析引起冠心病合并2型糖尿病患者心血管事件再发的相关危险因素。结果 188例患者中有70例在1年内再发心血管事件。各组患者年龄、HbA1c、TG、HDL-C、sdLDL-C差异有统计学意义(P<0.05)。Cox分析模型显示,吸烟史、2型糖尿病史、LDL-C、sdLDL-C和男性均是冠心病患者1年内心血管事件再发的危险因素(P<0.05)。Kaplan-Meier分析显示,各组“生存”分布的差异具有统计学意义(χ^(2)=24.616,P<0.01)。Pearson卡方检验分析显示,实验组患者1年内心血管事件再发率显著高于对照组(P=0.025,χ^(2)=5.033);在对照组(P=0.004,χ^(2)=8.362)和实验组(P=0.015,χ^(2)=5.905)中,高值组患者1年内心血管事件再发率均显著高于低值组。结论 血清sdLDL-C水平是冠心病合并2型糖尿病患者1年内再发心血管事件的独立危险因素,对冠心病合并2型糖尿病患者1年内再发心血管事件具有重要的预测价值。Objective To investigate the correlation between recurrent cardiovascular events and serum small and dense low-density lipoprotein cholesterol(sdLDL-C)levels in patients with coronary heart disease complicated with type 2 diabetes.Methods A totle of 188 patients with coronary heart disease(CHD)admitted to the Department of Cardiology of the Second Affiliated Hospital of Zhengzhou University from March 2020 to March 2021 who underwent angiography were selected,among whom the patients with combined type 2 diabetes(n=112)were as the experimental group and the other patients without combined type 2 diabetes(n=76)were as the control group.Serum sdLDL-C and other laboratory indicators were measured;and according to the optimal cutoff point of sdLDL-C level,the control group and the experimental group were divided into the control low value group(n=42),the control high value group(n=34),the experimental low value group(n=58)and the experimental high value group(n=54).All the patients were followed up for 1 year,and the general information and the recurrence of cardiovascular events within 1 year were recorded and compared between the groups;and the risk factors associated with the recurrence of cardiovascular events in the patients with coronary heart disease combined with type 2 diabetes were analyzed.Results 70 of the 188 patients had a recurrence of cardiovascular events within 1 year,including 49 in the experimental group and 21 in the control group.Comparing the general information of the patients,no significant differences were found in BMI,TC,LDL-C and gender between the groups(P>0.05)but the differences in age,HbA1c,TG,HDL-C and sdLDL-C between the groups were statistically significant(P<0.05).Cox analysis model showed that smoking history,history of type 2 diabetes,LDL-C,sdLDL-C and male were all the independent risk factors for recurrence of cardiovascular events within 1 year in patients with coronary heart disease(P<0.05 and the regression coefficients were all positive).The Kaplan-Meier method showed that t

关 键 词：小而密低密度脂蛋白胆固醇 冠心病 2型糖尿病 再发 

分 类 号：R541.4[医药卫生—心血管疾病]