作　　者： ;

机构地区： 广州医科大学

出　　处： 《中华肥胖与代谢病电子杂志》 2020年第2期91-95,共5页

摘　　要： 目的探讨Lp(a)与糖尿病患者PCI术后他汀类药物治疗的临床结局的关系。方法回顾性分析于2015年1月至2018年12月在广州医科大学附属第六医院经确诊为冠心病患者316例,根据纳入研究病例的Lp(a)水平,将患者分为高Lp(a)组和低Lp(a)组,对比两组患者的血压、糖化血红蛋白(HbA1c)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、超敏C反应蛋白(hsCRP)、氨基末端脑钠素前体(NT-proBNP)、左心射血分数(LVEF)水平,及用药情况,分析两组随访主要不良心脏事件(MACE)的发生情况。结果两组的收缩压、舒张压、HbA1c、TG、HDL-C、hsCRP、NT-proBNP、LVEF对比差异均无统计意义(P>0.05),而高Lp(a)组的LDL-C水平显著高于低Lp(a)组,差异具有统计学意义(P<0.001);两组患者阿司匹林、Β受体阻滞剂、CCB类、ACEI/ARB类药物用药情况的比例对比差异均无统计学意义(P>0.05)。高Lp(a)组的MACE发生率显著高于低Lp(a)组,差异具有统计学意义(HR:2.07,95%CI:1.281-3.542,P=0.027)。结论 PCI后接受他汀类药物治疗的糖尿病患者中血清高Lp(a)水平是不良心脏事件发生的独立风险因素。 Objective To explore the relationship between Lp(a)and clinical outcomes of statin therapy in diabetic patients after PCI.Methods A retrospective analysis of 316 patients diagnosed with coronary heart disease from January 2015 to December 2018 in our hospital was divided into high Lp(a)group and low Lp(a)group according to the Lp(a)level of the included cases.Blood pressure,glycated hemoglobin(HbA1c),triglyceride(TG),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),hypersensitive C-reactive protein(HsCRP),N-termina pro-brain natriuretic pep-tide(NT-proBNP),left ventricular ejection fraction(LVEF)levels were compared between the two groups,and medications were used to analyze the occurrence of major adverse cardiac events(MACE)during follow-up in both groups.Results There was no statistically significant difference in systolic blood pressure,diastolic blood pressure,HbA1c,TG,HDL-C,hsCRP,NT-proBNP,LVEF between the two groups(P>0.05),while the LDL-C level in the high Lp(a)group was significantly higher In the low Lp(a)group,the difference was statistically significant(P<0.001);the proportion of patients with aspirin,beta-blocker,CCB,ACEI/ARB medications in the two groups had no statistically significant differences in proportions(P>0.05).The incidence of MACE in the high Lp(a)group was significantly higher than that in the low Lp(a)group,and the difference was statistically significant(HR:2.07,95%CI:1.281-3.542,P=0.0057).Conclusions Serum high Lp(a)levels in diabetic patients receiving statin therapy after PCI are independent risk factors for adverse cardiac events.

关 键 词： 糖尿病 脂蛋白 他汀 不良心脏事件

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