上海市西北地区冠心病病变程度与营养指标的关系  

Relationship between the severity of coronary heart disease and nutritional status of patients

作　　者：姚云[1] 吴萍[1] 王加勇[2] 王菊 YAO Yun;WU Ping;WANG Jiayong;WANG Ju(Department of Clinical Nutrition,Tongji Hospital,School of Medicine,Tongji University,Shanghai 200065,China;Department of Blood Transfusion,Tongji Hospital,School of Medicine,Tongji University,Shanghai 200065,China;Clinical Laboratory,Qingpu Campus of Zhongshan Hospital,Fudan University,Shanghai 201700,China)

机构地区：[1]同济大学附属同济医院营养科,上海200065 [2]同济大学附属同济医院输血科,上海200065 [3]复旦大学附属中山医院青浦分院检验科,上海201700

出　　处：《同济大学学报（医学版）》2023年第4期569-573,共5页Journal of Tongji University(Medical Science)

摘　　要：目的分析上海市西北地区冠心病(coronary heart disease,CHD)营养指标的特点,探讨CHD病变严重程度与营养指标的关系。方法将同济大学附属同济医院心血管内科2021年9月—2022年5月130例确诊冠心病患者为研究对象纳入CHD组,分为亚组Ⅰ(50%≤内径狭窄<75%)74例,亚组Ⅱ(75%≤内径狭窄<100%)45例,亚组Ⅲ(完全闭塞梗死)11例;同期排除冠心病的128例体检者作为对照组。比较两组基线特征及营养指标,并探讨冠心病不同病变严重程度与基线特征及营养指标之间的相关性。结果CHD组男性占比及肱三头肌皮褶厚度(triceps skin-fold thickness,TSF)、体重指数(body mass index,BMI)、总胆固醇(total cholesterol,TC)、甘油三酯(triglyceride,TG)、低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)、载脂蛋白B(apolipoprotein B,Apo-B)、脂蛋白a[lipoprotein(a),LP(a)]、丙氨酸转氨酶(alanine aminotransferase,ALT)水平较对照组高,差异有统计学意义(P<0.05),CHD组高密度脂蛋白胆固醇(high-density lipoprotein cholesterol,HDL-C)、载脂蛋白A(apolipoprotein A,Apo-A)水平比对照组低,差异有统计学意义(P<0.05)。在CHD组中,亚组Ⅰ、亚组Ⅱ与亚组ⅢTC、HDL和LP(a)水平差异有统计学意义(P<0.05),TC、Lp(a)、HDL-C与冠心病病变程度相关(P<0.05),OR(95%CI)分别为1.54(1.0652.152)、1.759(1.2122.552)、0.325(0.1540.673)。结论高水平的TC、Lp(a)是上海市西北地区冠心病病变的危险因素,HDL-C是上海市西北地区冠心病病变的保护因子,CHD应加强营养防治。Objective To explore the the relationship between the severity of coronary heart disease(CHD)and nutritional status of patients.Methods A total of 130 CHD patients admitted in the Department of Cardiology of Tongji Hospital from September 2021 to May 2022 were enrolled(CHD group),including 74 cases with mild disease(50%≤stenosis<75%,subgroupⅠ),45 cases with intermediate disease(75%≤stenosis<100%,subgroupⅡ)and 11 cases with severe disease(total occlusion infarction,subgroupⅢ);128 healthy subjects served as the control group.The baseline characteristics and nutritional indicators of the two groups were compared,and the relationship between the disease severity and the nutritional indicators was analyzed.Results In CHD group the proportion of males,the levels of triceps skin-fold thickness(TSF),body mass index(BMI),total cholesterol(TC),triglyceride(TG),low-density lipoprotein cholesterol(LDL-C),apolipoprotein B(Apo-B),lipoprotein(a)[LP(a)],alanine aminotransferase(ALT)were higher than those in the control group(all P<0.05).The levels of high-density lipoprotein cholesterol(HDL-C)and apolipoprotein A(Apo-A)in CHD group were significantly lower than those in control group(P<0.05).There were significant differences in TC,HDL and LP(a)levels among subgroupⅠ,subgroupⅡand subgroupⅢof CHD patients(P<0.05).TC,Lp(a),HDL-C were correlated with the severity of CHD(OR=1.54,95%CI:1.065-2.152,OR=1.759,95%CI:1.212-2.552 and OR=0.325,95%CI:0.154-0.673;all P<0.05),respectively.Conclusion High levels of TC and Lp(a)are the risk factors of CHD,and HDL-C is the protective factor.Nutrition prevention and treatment of coronary heart disease should be strengthened.

关 键 词：冠心病 营养 相关性 

分 类 号：R541[医药卫生—心血管疾病]