弥漫性冠状动脉病变患者血脂异常的临床观察与探讨

Clinical observation of dyslipidemia in patients with diffuse coronary artery disease

目的探讨弥漫性冠状动脉病变患者的血脂特点,寻找冠状动脉粥样硬化发展至弥漫性病变的合适干预靶点。方法回顾性选取2007年1月至2013年12月于首都医科大学附属北京安贞医院就诊行选择性冠状静脉动脉化治疗的61例弥漫性冠状动脉病变患者为弥漫性病变组,同期通过倾向性得分匹配选取行常规冠状动脉旁路移植术的冠状动脉粥样硬化性心脏病患者60例为对照组。比较2组患者一般资料。结果弥漫性病变组患者术前心率、心肌梗死史比例、低密度脂蛋白胆固醇和三酰甘油水平均明显高于对照组[(70±16)次/min比(64±14)次/min、67.2%(41/61)比46.7%(28/60)、(2.7±0.8)mmol/L比(2.4±0.8)mmol/L、(1.8±0. 8)mmol/L比(1.4±0. 6)mmol/L],差异均有统计学意义(均P<0.05)。结论血脂控制不佳可能是冠状动脉粥样硬化发展至弥漫性病变的一个重要因素。血脂控制是冠状动脉粥样硬化性心脏病患者病情一个极其重要的干预靶点,临床医师应该给予更多的重视。

Objective To explore the characteristics of blood lipid levels in patients with diffuse coronary artery disease and to define a proper target for the treatment of diffuse coronary artery disease. Methods From January 2007 to December 2013, clinical data of 61 patients with diffuse coronary artery disease underwent selective coronary vein bypass grafting(observation group) and 60 patients with coronary heart disease underwent coronary artery bypass grafting(control group) in Beijing Anzhen Hospital, Capital Medical University were retrospectively analyzed. Results Before the operation, heart rate, myocardial infarction history ratio, low-density lipoprotein cholesterol and triglyceride levels in observation group were significantly higher than those in control group[(70±16)times/min vs (64±14)times/min, 67.2%(41/61) vs 46.7%(28/60), (2.7±0.8)mmol/L vs (2.4±0.8)mmol/L, (1.8±0.8)mmol/L vs (1.4±0.6)mmol/L](all P<0.05). Conclusions Poor blood lipid control may be an important factor in the process of coronary atherosclerosis developing into diffuse lesions. Blood lipid control is an important intervention target for coronary atherosclerotic heart disease.