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心肌梗死后二级预防中的降脂治疗

[Lipid lowering treatment in secondary prevention following myocardial infarct].

作者信息

Paragh G, Balogh Z, Boda J, Mohácsi A, Kovács P, Polgár P, Wórum F, Kakuk G

机构信息

Debreceni Orvostudományi Egyetem I. sz. Belgyógyászati Klinika.

出版信息

Orv Hetil. 1997 Jul 20;138(29):1849-53.

PMID:9280882
Abstract

1081 patients treated with myocardial infarction between 1990-1995 were investigated retrospectively, 652 (60.3%) of the patients were male and 429 (39.7%) were female. 154 (14.2%) patients had an early, while 927 (85.5%) patients had late myocardial infarction. Of the patients with early myocardial infarction 52.3% were smokers, 45.2% had positive family history for ischaemic heart disease or acute myocardial infarction. The lipid parameters were analysed in detail, because 83.3% of the patients were hyperlipoproteinaemic. The mean cholesterol level was 6.91 +/- 1.2 mmol/l, the HDL-C level was 1.19 +/- 0.38 mmol/l, the triglyceride level was 2.66 +/- 1.8 mmol/l, the LDL-C level was 4.71 +/- 1.2 mmol/l. The serum LDL-C and the HDL-C levels of the patients with early myocardial infarction were compared to the desirable levels suggested for secondary prevention. Only 7.2% of the male patients had a cholesterol level below 5.2 mmol/l, while all female patients cholesterol levels were above 5.2 mmol/l. Of the male patients 53.6%, while 78.6% of females had lower triglyceride levels than 2.3 mmol/l 78,6% of the male patients had higher protective HDL-C level in the optimal range (> 1.1 mmol/l). 12.5 percent of the male patients had an LDL-C level lower than the value targeted by secondary prevention (3.0 mmol/l), while all of the female patients LDL-C levels were higher. The authors emphasize the importance of secondary prevention and a more widespread use of lipid lowering treatment for patients after acute myocardial infarction.

摘要

对1990年至1995年间接受心肌梗死治疗的1081例患者进行了回顾性研究,其中男性患者652例(60.3%),女性患者429例(39.7%)。154例(14.2%)患者发生早期心肌梗死,927例(85.5%)患者发生晚期心肌梗死。在早期心肌梗死患者中,52.3%为吸烟者,45.2%有缺血性心脏病或急性心肌梗死的家族史阳性。由于83.3%的患者存在高脂蛋白血症,因此对血脂参数进行了详细分析。平均胆固醇水平为6.91±1.2mmol/L,高密度脂蛋白胆固醇(HDL-C)水平为1.19±0.38mmol/L,甘油三酯水平为2.66±1.8mmol/L,低密度脂蛋白胆固醇(LDL-C)水平为4.71±1.2mmol/L。将早期心肌梗死患者的血清LDL-C和HDL-C水平与二级预防建议的理想水平进行了比较。只有7.2%的男性患者胆固醇水平低于5.2mmol/L,而所有女性患者的胆固醇水平均高于5.2mmol/L。男性患者中有53.6%,而女性患者中有78.6%的甘油三酯水平低于2.3mmol/L。78.6%的男性患者具有处于最佳范围(>1.1mmol/L)的较高保护性HDL-C水平。12.5%的男性患者LDL-C水平低于二级预防目标值(3.0mmol/L),而所有女性患者的LDL-C水平均较高。作者强调了二级预防的重要性以及对急性心肌梗死后患者更广泛地使用降脂治疗。

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