急性心肌梗塞患者血脂水平分析

Plasma lipid changes after acute myocardial infarction

目的 探讨急性心肌梗塞 (AMI)患者的血脂水平及其对患者近期预后的影响。方法 对 4 47例AMI患者入院时的血清甘油三酯 (TG)、总胆固醇 (TC)、高密度脂蛋白 胆固醇 (HDL C)、低密度脂蛋白 胆固醇 (LDL C)、血清脂蛋白 (a) [Lp(a) ]、血浆氧化低密度脂蛋白 (OX LDL)进行测定 ,并根据患者年龄、是否吸烟 ,有无合并糖尿病、高血压病进行分组 ,比较各组间的血脂与预后关系。同时对患者住院 4周内死亡风险与其影响因素采用Logistic回归进行分析。 结果 心肌梗塞急性期TG≥ 2 .2mmol/L者占 13 % ,TG在 1.76～ 2 .2mmol/L者占 12 % ;TC≥ 6.2 4mmol/L者占 16% ,TC在 4 .68～ 6.2 4mmol/L的患者占 4 0 %。多元Logistic回归分析发现 :TC、LDL C是预测心肌梗塞急性期死亡的独立危险因素。结论 心肌梗塞患者急性期即可发现高脂血症。总胆固醇、低密度脂蛋白 胆固醇水平是最重要的心肌梗塞急性期死亡的独立危险因素。

Objective The purpose of this investigation was to discover the serum lipid level on the morning after acute myocardial infarction (AMI) and its relationship with smoking, diabetic mellitus (DM), hypertension, and the prognosis. Methods Plasma cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL C), high density lipoprotein cholesterol (HDL C), lipoprotein (a) [Lp(a)], oxidatively modified low density lipoprotein (OXLDL) were measured in 447 patients with proven acute myocardial infarction (AMI).Results In 13% of patients was the TG level increased. In 16% of patients was the TC level raised. The patients with increased Lp(a) level were characterized by a cluster of risk factors such as smoking and diabetic mellitus. Multiple analysis showed that increased TC, LDL C were positively correlated with cardiac death in hospital. Conclusion Serum lipid disorders were correlated with poor prognosis of AMI.