Agoşton-Coldea Lucica, Zdrenghea D, Pop Dana, Crăciun Alexandra, Rusu M L, Mocan Teodora
"Iuliu Haţieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.
Rom J Intern Med. 2007;45(4):341-7.
The purpose of the study was to evaluate the lipid profile and the prevalence of dyslipidaemia and other risk factors in subjects with and without coronary heart disease.
We conducted a retrospective study in 1519 subjects, admitted in Internal Medicine and Cardiology Department, Cluj-Napoca between January 2003 and December 2004. The first group consisted of 760 patients with coronary heart disease and the second group including 759 subjects in which coronary heart disease was excluded based on standard criteria. The cardiovascular risk factors and the serum lipid fractions were analyzed in order to test their relationship with the demographic characteristics and clinical forms of coronary heart disease.
The mean values of lipid fractions were lower in subjects with coronary heart disease than in subjects without coronary heart disease: total cholesterol (204.44 +/- 43.07 vs. 224.51 +/- 51.73 mg/dl, p = 0.0001), LDL-cholesterol (132.69 +/- 34.77 vs. 148.76 +/- 48.72 mg/dl, p = 0.0001), HDL-cholesterol (39.72 +/- 10.02 vs. 44.33 +/- 11.95 mg/dl, p = 0.0001), triglycerides (156.81 +/- 70.84 vs. 159.99 +/- 115.3 mg/dl, p = 0.517), non-HDL-cholesterol (164.72 +/- 39.9 vs. 180.19 +/- 51.58 mg/dl, p = 0.0001). The prevalence of dyslipidaemia was higher in group 1 than in group 2 (91.2% vs. 85.3%; p = 0.01). The most common lipid abnormalities in patients with coronary heat disease were increased LDL-C (84.22% vs. 81.21%, p = 0.09), followed by low HDL-C (55.26% vs. 35.57%, p = 0.001). The multivariate analysis showed that LDL-C (OR 1.27; 95% CI 1.01-1.88, p = 0.004), TC/HDL-C > 4.5 (OR 3.62; 95% CI 2.85-8.86, p = 0.001) and LDL-C/HDL-C > 3.5 (OR 4.21; 95% CI 1.89-4.66, p = 0.001) ratio, as being strongly associated with coronary events.
The study found a high prevalence of dyslipidaemia in Romanian patients with coronary heart disease. The most frequent lipid disorders were increased LDL-C, and low HDL-C. According to our results more than 90% of the patients with coronary heart disease are dyslipidaemic, and require non-pharmacological or pharmacological therapy.
本研究的目的是评估冠心病患者和非冠心病患者的血脂谱、血脂异常患病率及其他危险因素。
我们对2003年1月至2004年12月在克卢日 - 纳波卡内科和心脏病科住院的1519名受试者进行了一项回顾性研究。第一组由760例冠心病患者组成，第二组包括759名根据标准排除冠心病的受试者。分析心血管危险因素和血清脂质成分，以检验它们与冠心病的人口统计学特征和临床类型的关系。
冠心病患者的脂质成分平均值低于非冠心病患者：总胆固醇（204.44±43.07对224.51±51.73mg/dl，p = 0.0001）、低密度脂蛋白胆固醇（132.69±34.77对148.76±48.72mg/dl，p = 0.0001）、高密度脂蛋白胆固醇（39.72±10.02对44.33±11.95mg/dl，p = 0.0001）、甘油三酯（156.81±70.84对159.99±115.3mg/dl，p = 0.517）、非高密度脂蛋白胆固醇（164.72±39.9对180.19±51.58mg/dl，p = 0.0001）。第1组血脂异常患病率高于第2组（91.2%对85.3%；p = 0.01）。冠心病患者最常见的脂质异常是低密度脂蛋白胆固醇升高（84.22%对81.21%，p = 0.09），其次是高密度脂蛋白胆固醇降低（55.26%对35.57%，p = 0.001）。多因素分析显示，低密度脂蛋白胆固醇（OR 1.27；95%CI 1.01 - 1.88，p = 0.004）、总胆固醇/高密度脂蛋白胆固醇> 4.5（OR 3.62；95%CI 2.85 - 8.86，p = 0.001）和低密度脂蛋白胆固醇/高密度脂蛋白胆固醇> 3.5（OR 4.21；95%CI 1.89 - 4.66，p = 0.001）比值与冠心病事件密切相关。
该研究发现罗马尼亚冠心病患者血脂异常患病率很高。最常见的脂质紊乱是低密度脂蛋白胆固醇升高和高密度脂蛋白胆固醇降低。根据我们的结果，超过90%的冠心病患者存在血脂异常，需要非药物或药物治疗。
