老年住院患者血脂与非瓣膜性心房颤动的相关性研究
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南京医科大学科技发展基金(NMUB2018184)


Association between blood lipid profiles and non⁃valvular atrial fibrillation in elderly in⁃patients
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    摘要:

    目的:研究血脂与老年住院患者非瓣膜性心房颤动(房颤)的相关性及其性别差异。方法:分析南京医科大学附属老年医院心内科住院并符合纳入标准的758例老年患者,其中非瓣膜性房颤患者223例为房颤组,无房颤患者535例为对照,分析总人群、男性和女性房颤与血脂的相关性。结果:总人群房颤组的总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、甘油三酯(TG)均低于无房颤组(P < 0.05);按性别分组:男性房颤组的TC、LDL-C、TG较男性无房颤组显著降低(P < 0.01);上述血脂成分在女性房颤组与女性无房颤组差异无统计学意义(P > 0.05)。校正年龄等危险因素后行多因素Logistic回归分析,在总人群组中TC(P=0.012)、LDL-C(P=0.017)、TG(P=0.003)和房颤呈显著负相关,在男性组中TC(P=0.006)、LDL-C(P=0.020)和房颤呈显著负相关。根据TC、LDL-C数值进行分组比较房颤相对危险度(RR)的差异,随着TC和LDL-C的升高,男性房颤的发生风险呈现先高后低;TC≥5.2 mmol/L时,RR仅为TC<3.1 mmol/L时的0.094(P=0.027);当LDL-C≥3.4 mmol/L时,RR仅为LDL-C<1.8 mmol/L时的0.074(P=0.014)。结论:老年非瓣膜性房颤住院患者具有较低的TC、TG和LDL-C水平,较高水平的TC、LDL-C与较低的男性房颤风险相关,女性房颤的发生与血脂无显著相关性。

    Abstract:

    Objective:To investigate the relationship between blood lipid profiles and non-valvular atrial fibrillation(AF)in elderly in-patients,and to definite whether there exist differences between males and females. Methods:A total of 758 elderly in-patients who met the inclusion criteria hospitalized in the Department of Cardiology,Geriatric Hospital of Nanjing Medical University were included in this study,223 patients with non-valvular atrial fibrillation(AF group),the non-AF patients as control group(n=535),compare the correlation between AF and blood lipid profiles in general patients,male patients and female patients. Results:The general patients with AF had significantly lower levels of total cholesterol(TC),low density lipoprotein cholesterol(LDL-C),triglyceride(TG)than the non-AF patients(P < 0.05). Regrouping by gender,in male patients,the statistical results of blood lipid profiles were similar to those of the general patients,while in female patients,blood lipid profiles had no significant differences between the AF group and non-AF group. Multivariate logical regression analysis of the blood lipid profiles and AF was processed after constructing multiple models. In the general patients,TC(P=0.012),LDL-C(P=0.017),and TG(P=0.003)were negatively correlated with AF. In the male patients,TC(P=0.006),and LDL-C(P=0.020)were also negatively correlated with AF. According to the values of TC and LDL-C in atherosclerotic risk stratification,we compared the incidence of AF. With the increase of TC and LDL-C concentration,the prevalence of AF in men increased at first and then decreased. The prevalence of AF in the male patients with TC≥5.2 mmol/L was only 0.094(P=0.027)compared with the patients with TC<3.1 mmol/L,and the prevalence with LDL-C≥ 3.4 mmol/L was 0.074(P=0.014)compared with the patients with LDL-C<1.8 mmol/L. Conclusion:Elderly in-patients with non-valvular AF had lower levels of TC,TG and LDL-C. Higher levels of TC and LDL-C were associated with lower prevalence rate of AF only in males. There were no significant differences between the prevalences of AF in women by TC and LDL-C risk stratification.

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董红科,马东超,李 静,王 屹,郭红梅,熊亚晴.老年住院患者血脂与非瓣膜性心房颤动的相关性研究[J].南京医科大学学报(自然科学版),2020,(10):1484-1490

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  • 收稿日期:2019-12-31
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  • 在线发布日期: 2020-11-10
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