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通过当地登记数据,利用颈动脉双功扫描对40岁以下患者进行家族性高胆固醇血症筛查。

Screening of familial hypercholesterolemia among patients in age under 40 years old exposed by duplex scanning of carotid arteries, by the local registry data.

作者信息

Gaisenok O V, Kurnosov P A, Leonov A S, Zateeyshikov D A

机构信息

Federal State Budgtary Institution "United Hospital with a Polyclinic" of the Department of Presidential Affairs of the Russian Federation, Moscow, Russia.

Federal State Budgtary Institution "Central State Medical Academy" of the Department of Presidential Affairs of the Russian Federation, Moscow, Russia.

出版信息

Ter Arkh. 2018 Sep 20;90(9):37-41. doi: 10.26442/terarkh201890937-41.

Abstract

AIM

To identify patients with probable FH among Duplex-2013 registry patients under the age of 40 years, to analyze their lipid spectrum and duplex carotid artery data, to evaluate the changes of their lipid spectrum parameters.

MATERIALS AND METHODS

The Duplex-2013 registry database was used for this study (n=2550). Patients under the age of 40 years were selected for follow-up analysis (n=192).

RESULTS

20 of them were selected on the basis of Simon Broome criteria as patients with possible FH. The FH group (n=20) and the control group (n=172) had significant differences in age (35.1 ± 4.01 vs. 32.62 ± 5.29, p=0.044), male gender (18 of 20 (90%) vs 92 of 172 (53%), p=0.003), TC (7.64 ± 0.63 vs 5.34 ± 0.91, p=0.0001) and LDL-C cholesterol (5.45 ± 0.62 vs 3.28 ± 0.78, p=0.00001). When comparing the groups by the combined criterion of atherosclerosis (IMT > 1.0 mm and / or atherosclerotic plaque in the carotid artery >20%), it was noted that signs of carotid atherosclerosis were more often recorded in the FH group compared with the control group (40% vs 26%). Repeated laboratory studies of TC and LDL-C in the FH group after 2.5 years showed their significant dynamics (7.64 ± 0.63 vs 6.03 ± 1.04, p=0.007, 5.45 ± 0.63 vs 3.84 ± 1.24, p=0.035).

CONCLUSION

The frequency of detection of FH in the cohort study was 1:10 (11% of all patients). Thus, patients referred for duplex scanning of carotid arteries can be a potential target for screening for FH.

摘要

目的

在Duplex - 2013登记研究的40岁以下患者中识别可能患有家族性高胆固醇血症(FH)的患者,分析他们的血脂谱和双侧颈动脉数据,评估其血脂谱参数的变化。

材料与方法

本研究使用Duplex - 2013登记数据库(n = 2550)。选取40岁以下患者进行随访分析(n = 192)。

结果

根据西蒙·布鲁姆标准,其中20例被选为可能患有FH的患者。FH组(n = 20)和对照组(n = 172)在年龄(35.1 ± 4.01 vs. 32.62 ± 5.29,p = 0.044)、男性比例(20例中的18例(90%)vs 172例中的92例(53%),p = 0.003)、总胆固醇(TC)(7.64 ± 0.63 vs 5.34 ± 0.91,p = 0.0001)和低密度脂蛋白胆固醇(LDL - C)(5.45 ± 0.62 vs 3.28 ± 0.78,p = 0.00001)方面存在显著差异。按照动脉粥样硬化的综合标准(内膜中层厚度(IMT)> 1.0 mm和/或颈动脉粥样硬化斑块> 20%)对两组进行比较时,发现FH组与对照组相比,颈动脉粥样硬化体征的记录更为常见(40% vs 26%)。FH组在2.5年后对TC和LDL - C进行的重复实验室研究显示其有显著变化(7.64 ± 0.63 vs 6.03 ± 1.04,p = 0.007,5.45 ± 0.63 vs 3.84 ± 1.24,p = 0.035)。

结论

队列研究中FH的检出率为1:10(占所有患者的11%)。因此,接受颈动脉双功扫描的患者可能是FH筛查的潜在对象。

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