高密度脂蛋白胆固醇与冠心病介入治疗患者预后的关系分析

Analysis of prognosis in coronary heart disease with interventional therapy between high density lipoprotein cholesterol at the time of admission

目的分析不同水平高密度脂蛋白胆固醇（HDL-C）对冠心病介入治疗患者预后的影响。方法选择2010年1月-2011年6月首都医科大学大兴医院的冠心病患者171例，根据患者入院时HDL-C水平的中位数值（1．32mmol／L，n=82）将患者分为HDL—C高水平组（HDL—C≥1．32mmol／L，n=89）和HDL—C低水平组（HDL—C〈1．32mmol／L），对两组患者的预后情况进行随访。结果高水平HDL-C组患者在随访1年内共发生14例不良心血管事件，低水平HDL—C组患者在随访1年内共发生29例不良心血管事件。两组患者比较，差异有统计学意义（X^2=5．455，P=0．020）；年龄≥50岁（OR=1．619，95％CI1．119～2．342）、吸烟史（OR=1．652，95％CI1．214～2．248）、男性（OR=1．447，95％CI1．023～2．046）、糖尿病（OR=1．536，95％CI1．118～2．110）、BMI≥25kg／m0（OR=1．372，95％CI1．012～1．945）是患者在随访期内发生不良心血管事件的危险因素，HDL—C≥1．32mmol／L（OR=0．423，95％C10．227～0．788）是患者在随访期内发生不良心血管事件的保护因素。结论高水平HDL—C可以降低冠心病经皮冠状动脉介入（PCI）治疗术后患者的不良心血管事件发生率。

Objective To analyse the influence on prognosis in coronary heart disease with interventional therapy between different levels of high density lipoprotein cholesterol at the time of admission. Methods 171 cases of coronary heart disease from January 2010 to June 2011 in Capital University Daxing Hospital were selected and devided into HDL-C high level group （HDL-C ≥1.32 mmol/L） and low levels of HDL-C group （HDL-C〈1.32 mmol/L） according to the patients at admission in HDL-C median numerical （1.32 mmol/L）, the prognosis of two group patients were followup. Results 14 cases of adverse cardiovascular events in high levels in the HDL-C group patients in the follow-up of 1 years, 29 cases of adverse cardiovascular events in low levels of HDL-C in patients in the follow-up of 1 years. The two group of patients were compared, the difference was statistically significant （X^2 = 5.455, P = 0.020）; above 50 years of age （OR = 1.619, 95%CI 1.119-2.342）, smoking history （OR = 1.652, 95%CI = 1.214-2.248）, the male （OR = 1.447, 95%CI = 1.023-2.046）, diabetes mellitus （OR = 1.536, 95%CI 1.118-2.110）, BMI≥25 kg/m2 （OR = 1.372, 95%CI 1.012-1.945） was risk factors of incidence of adverse cardiovascular events for patients during the follow-up period, HDL-C ≥1.32 mmol/L （OR = 0.423, 95%CI 0.227-0.788） was protective factors of incidence of adverse cardiovascular events for patients during the follow-up period. Conclusion High levels of HDL-C can reduce adverse cardiovascular event rate of coronary heart disease patients after PCI.