血脂异常对冠心病患者运动耐量的影响  

Effects of dyslipidemia on exercise tolerance in patients with coronary heart disease

作　　者：余子阳 张雪晴 李燕萍[1] 李婷婷 何秀玲[1] 林明仙[1] 李碧 王婷 郝应禄[1] YU Zi-yang;ZHANG Xue-qing;LI Yan-ping;LI Ting-ting;HE Xiu-ling;LIN Ming-xian;LI Bi;WANG Ting;HAO Ying-lu(Department of Cardiology,People's Hospital of Yuxi City,Yuxi,Yunnan,653199,China)

机构地区：[1]玉溪市人民医院心内科,云南玉溪653199 [2]玉溪市人民医院内分泌与代谢性疾病科,云南玉溪653199

出　　处：《心血管康复医学杂志》2024年第2期123-127,共5页Chinese Journal of Cardiovascular Rehabilitation Medicine

基　　金：2017年度云南省医学领军人才培养项目(L-2017007)。

摘　　要：目的:探讨血脂异常对冠心病患者运动耐量的影响。方法:收集2019年1月至2020年1月在玉溪市人民医院心内科就诊的297例冠心病患者作为研究对象,根据峰值千克摄氧量占预计值的百分比是否<80%,分为运动耐量正常组(43例)和运动耐量下降组(254例)。比较分析两组一般资料及总胆固醇(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)和极低密度脂蛋白胆固醇(vLDL-C)水平。分析冠心病患者运动耐量下降的影响因素,并利用ROC曲线评估血脂对冠心病患者运动耐量下降的预测价值。结果:多因素Logistic回归在校正了年龄、吸烟史、饮酒史、高血压史、糖尿病史、心肌梗死史、经皮冠脉介入(PCI)术后史后发现,HDL-C为冠心病患者运动耐量下降的独立保护因素(OR=0.251,P=0.020)。经ROC曲线分析,TG、HDL-C和vLDL-C预测冠心病患者运动耐量下降的曲线下面积分别为0.591、0.663和0.587,截断值分别为1.83mmol/L、1.02mmol/L和0.87mmol/L,敏感性分别为44.09%、50.00%和35.83%,特异性分别为79.07%、79.07%和86.05%。结论:HDL-C是冠心病患者运动耐量下降的独立保护因素,并在一定程度上可以预测冠心病患者的运动耐量下降。Objective:To investigate the effects of dyslipidemia on exercise tolerance in patients with coronary heart disease(CHD).Methods:A total of 297 CHD patients,who were treated in Department of Cardiology of People's Hospital of Yuxi City from January 2019 to January 2020,were recruited.Patients were divided into normal exercise tolerance group(n=43)and reduced exercise tolerance group(n=254)according to whether the VO 2/kg@AT%Pred<80%.General data,levels of total cholesterol(TC),triglyceride(TG),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C)and very low density lipoprotein cholesterol(vLDL-C)were compared and analyzed between two groups.Influencing factors for reduced exercise tolerance in CHD patients were analyzed,and the ROC curve was used to evaluate the predictive value of blood lipids for reduced exercise tolerance in CHD patients.Results:Multivariate Logistic regression analysis showed that after adjusting for age,histories of smoking,drinking,hypertension,diabetes mellitus,myocardial infarction and post-percutaneous coronary intervention(PCI),HDL-C was an independent protective factor for reduced exercise tolerance in CHD patients(OR=0.251,P=0.020).ROC curve analysis showed that the area under the ROC curve(AUC)of TG,HDL-C and vLDL-C was 0.591,0.663 and 0.587 respectively;the cut-off value was 1.83mmol/L,1.02mmol/L and 0.87mmol/L respectively,sensitivity was 44.09%,50.00% and 35.83% respectively,and the specificity was 79.07%,79.07% and 86.05% respectively in predicting reduced exercise tolerance in CHD patients.Conclusion:HDL-C serves as an independent protective factor of reduced exercise tolerance in CHD patients,and can predict reduced exercise tolerance in CHD patients to a certain extent.

关 键 词：冠状动脉疾病 血脂异常 运动耐量 

分 类 号：R541.409[医药卫生—心血管疾病]