| 杨莹,栾桂霞,孙亚欧,等.老年不稳定型心绞痛患者血脂水平与颈动脉粥样硬化和胰岛素抵抗的相关性[J].中国临床保健杂志,2022,25(5):678-681. |
| 老年不稳定型心绞痛患者血脂水平与颈动脉粥样硬化和胰岛素抵抗的相关性 |
| Correlation of blood lipids levels with carotid atherosclerosis and insulin resistance in elderly patients with unstable angina pectoris |
| 投稿时间：2022-08-03 |
| DOI：10.3969/J.issn.1672-6790.2022.05.022 |
| 中文关键词: 心绞痛,不稳定型 动脉粥样硬化 胰岛素抵抗 血脂异常 老年人 |
| 英文关键词: Angina,unstable Atherosclerosis Insulin resistance Dyslipidemias Aged〖FL |
| 基金项目: |
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| 中文摘要: |
| 目的 探讨老年不稳定型心绞痛(UAP)患者血脂水平与颈动脉粥样硬化和胰岛素抵抗(IR)的相关性。方法 收集中国人民解放军总医院京北医疗区2019年1月至2021年12月收治的72例UAP老年患者临床资料,根据《中国成人血脂异常防治指南(2016年修订版)》高血脂标准[空腹三酰甘油(TG)≥1.80 mmol/L或总胆固醇(TC)≥5.18 mmol/L],将患者分为高血脂组与非高血脂组,高血脂组41例,非高血脂组31例。比较2组基线资料及入院后空腹外周血胰岛素抵抗指数(IRI)、颈动脉内膜中层厚度(IMT)及血脂[TG、TC、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)],采用Pearson相关系数评估UAP老年患者TG、TC与IRI、IMT的相关性；并将出院后6个月因心血管症状入院的患者作为再入院组,未因心血管症状再入院者为未再入院组,记录其初入院、出院及再入院时的TG、TC、IRI、IMT水平变化。结果 高血脂组空腹胰岛素、TG、TC、LDL-C及IRI、IMT显著高于非高血脂组(P＜0.05),HDL-C则低于非高血脂组(P＜0.05)。Pearson相关系数分析显示,UAP老年患者TG、TC与IRI、IMT互呈正相关(P＜0.05)。再入院组25例,未再入院组47例,2组出院时TG、TC、IRI、IMT均较初入院时降低(P＜0.05),且再入院组初入院时TG、IRI及出院时TG、TC、IRI、IMT均高于未再入院组(P＜0.05)；再入院组再入院时TG、TC、IRI、IMT均显著高于出院时(P＜0.05)。结论 脂代谢紊乱、颈动脉粥样硬化及IR可能共同参与UAP的发生发展,其有望成为老年UAP患者病情进展的风险因子。 |
| 英文摘要: |
| Objective To explore the correlation between blood lipids levels and carotid atherosclerosis and insulin resistance (IR) in elderly patients with unstable angina pectoris (UAP).Methods The clinical data of 72 elderly patients with UAP treated in the hospital were collected between January 2019 and December 2021.According to the hyperlipidemia standard[fasting triacylglycerol (TG)≥1.80 mmol/L or total cholesterol (TC)≥5.18 mmol/L]of "2016 Chinese Guideline for the Management of Dyslipidemia in Adults",the patients were divided into hyperlipidemia group and non-hyperlipidemia group.There were 41 cases in hyperlipidemia group and 31 cases in non-hyperlipidemia group.The baseline data as well as fasting peripheral blood insulin resistance index (IRI),carotid intima-media thickness (IMT) and blood lipids[TG,TC,low-density lipoprotein cholesterol (LDL-C),high-density lipoprotein cholesterol (HDL-C)]after admission were compared between the two groups.Pearson correlation coefficient was used to evaluate the correlation of TG and TC with IRI and IMT in elderly patients with UAP.Patients who were admitted to hospital due to cardiovascular symptoms at 6 months after discharge were regarded as readmission group,and the patients who were not readmitted due to cardiovascular symptoms were set as non-readmission group,and the changes in TG,TC,IRI and IMT at initial admission,at discharge and at readmission were recorded.Results The fasting insulin,TG,TC,LDL-C,IRI,and IMT in hyperlipidemia group were significantly higher than those in non-hyperlipidemia group (P<0.05) while HDL-C was lower than that in non-hyperlipidemia group (P<0.05).Pearson correlation coefficient analysis showed that TG and TC were positively correlated with IRI and IMT in elderly patients with UAP (P<0.05).There were 25 cases in readmission group and 47 cases in non-readmission group.The TG,TC,IRI,and IMT at discharge in both groups were reduced compared with those at initial admission (P<0.05),and the TG and IRI at initial admission and TG,TC,IRI,and IMT at discharge in readmission group were higher than those in non-readmission group (P<0.05).The TG,TC,IRI,and IMT in readmission group at readmission were significantly higher than those at discharge (P<0.05).Conclusions Lipid metabolism disorder,carotid atherosclerosis and IR may jointly participate in the occurrence and development of UAP,which are expected to be risk factors for disease progression in elderly patients with UAP. |
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