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目的了解老年冠心病(CHD)患者血脂、C反应蛋白(CRP)及血液流变学水平,为老年CHD前瞻性临床研究和治疗提供依据。方法收集2012年9月至2014年5月本院收治的127例老年CHD患者的临床资料,进行血脂、CRP和血液流变学指标检测。结果老年CHD患者总胆固醇(TC)、甘油三酯(TG)和低密度脂蛋白胆固醇(LDL-C)平均水平超出正常参考值范围,与对照组相比,TC、TG和LDL-C水平明显高于对照组,差异均有统计学意义(P<0.01),高密度脂蛋白胆固醇(HDL-C)、磷脂(PL)、脂蛋白(a)[Lp(a)]和游离脂肪酸(FFA)平均水平均在正常参考值范围内。59.06%、58.27%、51.18%和18.11%的老年CHD患者分别有TC、TG、LDL-C和HDL-C异常,并且绝大多数都表现出肥胖和高血压,均明显高于对照组,差异均有统计学意义(P<0.01),而在年龄、性别、低血压、锻炼和睡眠方面差异均无统计学意义(P>0.05)。与对照组相比,老年CHD患者CRP水平、全血高切黏度、低切黏度、血浆黏度、红细胞比容、红细胞聚集指数和刚性指数均明显高于对照组,差异均有统计学意义(P<0.01),而血沉、红细胞变形指数以及双侧大脑中动脉(MCA)、大脑前动脉(ACA)、颈内动脉末端(TICA)、大脑后动脉(PCA)、椎动脉(VA)和基底动脉(BA)平均流速均明显低于对照组,差异均有统计学意义(P<0.05,P<0.01)。结论老年CHD患者主要以TC、TG和LDL-C异常为主,血液呈浓、黏、聚和凝的状态。
Objective To understand the levels of serum lipids, C-reactive protein (CRP) and hemorheology in elderly patients with coronary heart disease (CHD) and provide evidence for prospective clinical study and treatment of elderly CHD. Methods The clinical data of 127 elderly CHD patients admitted to our hospital from September 2012 to May 2014 were collected for the detection of blood lipid, CRP and hemorheology indexes. Results The average levels of total cholesterol (TC), triglyceride (TG) and low density lipoprotein cholesterol (LDL-C) in the elderly patients with CHD were beyond the normal reference range, and TC, TG and LDL-C levels were significantly higher than those in the control group (P <0.01), high density lipoprotein cholesterol (HDL-C), phospholipid (PL), lipoprotein (a) [Lp (a)] and free fatty acid (FFA) were higher than those in the control group The average level is within the normal reference range. The prevalences of TC, TG, LDL-C and HDL-C in 59.06%, 58.27%, 51.18% and 18.11% of elderly patients with CHD were obese and most of them showed obesity and hypertension, both of which were significantly higher than those of the control group (P <0.01), but there was no significant difference in age, sex, hypotension, exercise and sleep (P> 0.05). Compared with the control group, the levels of CRP, whole blood high shear viscosity, low shear viscosity, plasma viscosity, hematocrit, erythrocyte aggregation index and rigidity index in elderly CHD patients were significantly higher than those in the control group (P (P <0.01), while the ESR, erythrocyte deformability index and the indexes of MCA, ACA, TICA, PCA, VA and basilar artery (BA) were significantly lower than the control group, the difference was statistically significant (P <0.05, P <0.01). Conclusion The main causes of CHD in elderly patients are abnormal TC, TG and LDL-C, and the blood is in the state of thick, sticky, aggregated and condensed.