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目的研究高胆固醇血症患者跟腱厚度(ATT)的相关影响因素,对高胆固醇血症伴有跟腱增厚的患者进行综合防治。方法收集2014年3月至2015年3月年龄在18~70岁之间的高胆固醇血症患者104例,其中男性50例,女性54例。将患者分为ATT增厚组(ATT≥9 mm)和ATT正常组(ATT<9 mm),比较两组之间一般临床资料的差异,并采用Logistic回归模型对高胆固血症患者ATT的相关因素进行单因素和多因素分析。结果 ATT增厚组和ATT正常组在体重(63.70±11.16 kg比56.45±9.96 kg)、身高(162.91±6.48 cm比160.08±6.90 cm)、体质指数(24.03±3.30 kg/m2比22.17±2.83 kg/m2)、总胆固醇(8.47±1.39 mmol/L比7.67±1.94 mmol/L)、低密度脂蛋白胆固醇(6.14±0.99 mmol/L比5.12±0.13 mmol/L)、高密度脂蛋白胆固醇(1.17±0.42 mmol/L比1.97±1.31 mmol/L)、载脂蛋白AI(1.18±0.26 mmol/L比1.62±0.21 mmol/L)方面差异具有统计学意义。Logistic单因素回归分析显示,不同身高(OR=1.604,95%CI为1.002~1.129)、体质指数(OR=1.271,95%CI为1.064~1.390)、总胆固醇(OR=1.391,95%CI为1.014~1.715)、高密度脂蛋白胆固醇(OR=0.028,95%CI为0.007~0.115)、低密度脂蛋白胆固醇(OR=2.385,95%CI为1.494~3.807)、载脂蛋白AI(OR=0.006,95%CI为0.001~0.046)的高胆固醇血症患者ATT差异显著。Logistic多因素回归分析显示,在高胆固醇血症患者中,低密度脂蛋白胆固醇(OR=1.871,95%CI为1.067~3.280)是ATT的独立危险因素,高密度脂蛋白胆固醇(OR=0.099,95%CI为0.017~0.573)和载脂蛋白AI(OR=0.035,95%CI为0.003~0.412)为ATT的保护性因素。结论伴有ATT增厚的高胆固醇血症患者具有更高的血清胆固醇水平,低密度脂蛋白胆固醇为独立危险因素,高密度脂蛋白胆固醇和载脂蛋白AI为保护性因素。因此,应该对伴有ATT增厚的高胆固醇血症患者的危险因素进行防治,强化降胆固醇治疗。
Objective To study the related factors of Achilles tendon thickness (ATT) in patients with hypercholesterolemia and to make a comprehensive prevention and treatment of hypercholesterolemia patients with Achilles tendon thickening. Methods A total of 104 patients with hypercholesterolemia between March 2014 and March 2015 were collected, including 50 males and 54 females. The patients were divided into ATT group (ATT≥9 mm) and ATT group (ATT <9 mm). The differences of general clinical data between the two groups were compared. Logistic regression model was used to detect the ATT of hypercholesterolemia patients Related factors for single factor and multivariate analysis. Results The body weight (63.70 ± 11.16 kg vs 56.45 ± 9.96 kg), height (162.91 ± 6.48 cm vs 160.08 ± 6.90 cm), body mass index (24.03 ± 3.30 kg / m2 vs 22.17 ± 2.83 kg / m2), total cholesterol (8.47 ± 1.39 mmol / L vs 7.67 ± 1.94 mmol / L), low density lipoprotein cholesterol (6.14 ± 0.99 mmol / L vs 5.12 ± 0.13 mmol / L), high density lipoprotein cholesterol ± 0.42 mmol / L vs 1.97 ± 1.31 mmol / L) and apolipoprotein AI (1.18 ± 0.26 mmol / L vs 1.62 ± 0.21 mmol / L) were statistically significant. Logistic regression analysis showed that body mass index (OR = 1.271, 95% CI: 1.064-1.390), total cholesterol (OR = 1.391, 95% CI 1.014-1.715), high density lipoprotein cholesterol (OR = 0.028, 95% CI 0.007-0.11), low density lipoprotein cholesterol (OR = 2.385, 95% CI 1.494-3.807), apolipoprotein AI 0.006, 95% CI 0.001 ~ 0.046) hypercholesterolemia patients ATT significant difference. Logistic regression analysis showed that in patients with hypercholesterolemia, LDL cholesterol (OR = 1.871, 95% CI 1.067-3.280) was an independent risk factor for ATT. High density lipoprotein cholesterol (OR = 0.099, 95% CI 0.017-0.573) and apolipoprotein AI (OR = 0.035, 95% CI 0.003-0.412) were protective factors for ATT. Conclusions Patients with hypercholesterolemia associated with thickened ATT have higher serum cholesterol levels, and LDL cholesterol is an independent risk factor. High density lipoprotein cholesterol and apolipoprotein AI are protective factors. Therefore, risk factors associated with hypercholesterolemia associated with thickened ATT should be controlled and cholesterol-lowering therapy should be intensified.