摘要
目的评价Lipoprint法检测的LDL亚型在老年患者中的分布特点及其与动脉粥样硬化的关系。方法选择我院心内科住院患者224例,按年龄分为3组,A组(年龄<60岁)48例,B组(年龄60～79岁)137例,C组(年龄≥80岁)39例。应用Lipoprint脂蛋白分类检测系统对LDL细分类胆固醇及血脂4项定量分析,应用彩色多普勒超声检测仪测量颈总动脉内膜中层厚度及动脉粥样硬化斑块,回顾性分析比较3组临床资料,并进行logistic回归分析。结果 3组体质量指数及血脂、极低密度脂蛋白(VLDL)、小而密低密度脂蛋白(sdLDL)、LDL3、LDL4、非高密度脂蛋白(nonHDL)、TC、TG存在差异,与A组比较,B组VLDL、TG降低,B组、C组体质量指数偏低,VLDL、LDL、sdLDL、LDL3、LDL4、LDL5、LDL6、nonHDL、TC、TG降低,差异有统计学意义(P<0.05)。与A组比较,C组男性比例低(48.7%vs 72.9%)、高血压(82.1%vs 60.4%)和颈动脉斑块比例增高(82.1%vs 53.2%),差异有统计学意义(P<0.05)。多因素logistic回归分析显示,年龄、性别、HbA1c对颈动脉内膜中层厚度有预测价值,年龄、性别对颈动脉斑块有预测价值。结论老年患者血浆LDL亚型分布不同于年轻人,其分布特点与颈动脉内中膜厚度及斑块的相关性不明确,颈动脉内膜中层厚度及斑块的严重程度主要与年龄和性别有关。
Objective To evaluate the relationship between distribution characteristics of LDL subtypes and atherosclerosis in elderly patients.Methods Two hundred and twenty-four patients admitted to our hospital were divided into<60 years old group as group A(n=48),60-80 years old group as group B(n=137),and≥80 years old group as group C(n=39).Their serum levels of LDL-C,blood lipids and carotid artery IMT were measured,their atherosclerotic plaques were detected and their clinical data were compared and analyzed by logistic regression analysis.Results The BMI and serum levels of VLDL,sdLDL,LDL3,LDL4,non-HDL,TC,TG were different in 3 groups(P<0.05).The BMI was lower in elderly patients than in young patients,and the serum levels of VLDL,LDL,sdLDL,LDL3,LDL4,LDL5,LDL6,non-HDL,TC,TG were lower in group C than in group A(P<0.05).The serum levels of VLDL and TG were lower in group B than in group A.The number of male patients was smaller(48.7%vs 72.9%),the incidence of hypertension(82.1%vs 60.4%)and carotid atherosclerosis was higher(82.1%vs 53.2%)in group C than in group A(P<0.05).Multivariate logistic regression analysis showed that age,gender and HbA1 cwere the predictors of carotid IMT while age and gender were the predictors of carotid plaques.Conclusion The distribution of plasma LDL subtypes is different between elderly and young patients.The distribution characteristics of LDL subtypes are not related with carotid IMT and plaques while age and gender are closely related with carotid IMT and plaques.
作者
刘广彬
龚开政
张振刚
薛强
Liu Guangbin;Gong Kaizheng;Zhang Zhengang;Xue Qiang(Department of Cardiology,Affiliated Hospital of Yangzhou University,Yangzhou University)
出处
《中华老年心脑血管病杂志》
CAS
北大核心
2019年第3期232-235,共4页
Chinese Journal of Geriatric Heart,Brain and Vessel Diseases
基金
中华医学会心血管分会领航基金(LHJJ20140321)
