Qiu Weiyu, Chen Jiali, Huang Xianzhen, Guo Jun
Department of Cardiology, The First Affiliated Hospital of Jinan University, 613 Huangpu Da Dao Xi, Guangzhou, 510630, Guangdong, China.
Department of Transitional care, The First Affiliated Hospital of Jinan University, 613 Huangpu Da Dao Xi, Guangzhou, 510630, Guangdong, China.
Lipids Health Dis. 2020 Jul 6;19(1):163. doi: 10.1186/s12944-020-01340-5.
Coronary heart disease (CHD) is one of the leading causes of death worldwide. Percutaneous coronary intervention (PCI) has been an important technology for the treatment of CHD. Blood lipid management is critical for PCI patients because not only should local vascular pathological changes be considered but the whole atherosclerotic process should be considered as well.
A total of 522 patients diagnosed with CHD (including acute myocardial infarction and unstable angina) successfully underwent stent implantation in acute or elective PCI in the cardiology department of one general hospital in Guangzhou from June 2015 to December 2017. The 2016 Chinese Guideline for the Management of dyslipidaemia in Adults and the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report (NCEP-ATP III) were used to classify total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) levels.
A total of 522 patients were recruited for the study. The mean values of TC, TG, LDL-C, and HDL-C at baseline were 4.76, 1.80, 2.93 and 1.03 mmol/L, respectively. After 1 year of follow-up, the mean values of TC, TG, LDL-C, and HDL-C were 3.94, 1.62, 2.26 and 1.01 mmol/L, respectively. The prevalence of high TC, high TG, high LDL-C and low HDL-C at baseline was 12.05, 21.80, 10.90 and 56.79%, respectively, and the prevalence at follow-up was 4.59, 15.68, 3.25 and 59.85%, respectively. Logistic regression revealed that gender was risk factor for high TC (≥ 6.22 mmol/L), low HDL-C (< 1.04 mmol/L) and high LDL-C (≥ 4.14 mmol/L) at follow-up. Age was the factor associated with high TG (≥ 2.26 mmol/L) and low HDL-C (< 1.04 mmol/L) at follow-up. Besides, smoking and diet control were risk factors for low HDL-C (< 1.04 mmol/L) and high LDL-C (≥ 4.14 mmol/L) at follow-up, respectively.
The patients with PCI at follow-up experienced lower mean values of lipids and prevalence of dyslipidaemia than those at baseline. Gender, age, smoking and diet control were the risk factors associated with elevated lipids. Improvement in lipid management at follow up demonstrated that such intervention can be effective.
冠心病（CHD）是全球主要的死亡原因之一。经皮冠状动脉介入治疗（PCI）一直是治疗冠心病的一项重要技术。血脂管理对PCI患者至关重要，因为不仅要考虑局部血管病理变化，还应考虑整个动脉粥样硬化进程。
2015年6月至2017年12月，广州某综合医院心内科共522例诊断为冠心病（包括急性心肌梗死和不稳定型心绞痛）的患者在急性或择期PCI中成功接受了支架植入。采用2016年《中国成人血脂异常防治指南》和美国国家胆固醇教育计划（NCEP）成人高胆固醇血症检测、评估和治疗专家委员会（成人治疗小组III）最终报告（NCEP-ATP III）对总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL-C）和高密度脂蛋白胆固醇（HDL-C）水平进行分类。
共纳入522例患者进行研究。基线时TC、TG、LDL-C和HDL-C的平均值分别为4.76、1.80、2.93和1.03 mmol/L。随访1年后，TC、TG、LDL-C和HDL-C的平均值分别为3.94、1.62、2.26和1.01 mmol/L。基线时高TC、高TG、高LDL-C和低HDL-C的患病率分别为12.05%、21.80%、10.90%和56.79%，随访时患病率分别为4.59%、15.68%、3.25%和59.85%。逻辑回归显示，性别是随访时高TC（≥6.22 mmol/L）、低HDL-C（<1.04 mmol/L）和高LDL-C（≥4.14 mmol/L）的危险因素。年龄是随访时高TG（≥2.26 mmol/L）和低HDL-C（<1.04 mmol/L）的相关因素。此外，吸烟和饮食控制分别是随访时低HDL-C（<1.04 mmol/L）和高LDL-C（≥4.14 mmol/L）的危险因素。
随访时接受PCI治疗的患者血脂平均值和血脂异常患病率低于基线时。性别、年龄、吸烟和饮食控制是血脂升高的危险因素。随访时血脂管理的改善表明这种干预是有效的。
