急性冠脉综合征经皮冠状动脉介入治疗患者出院后血脂状况调查

目的 调查急性冠脉综合征经皮冠状动脉介入(PCI)治疗后患者低密度脂蛋白胆固醇(LDL-C)的水平及达标状况。方法 采用回顾性调查方法,纳入121例经PCI治疗的急性冠脉综合征患者,出院后常规服用他汀类药物,2019年7月于天坛医院心内科冠心病介入门诊复诊,记录患者出院后1~3个月、3~6个月、6~12个月及1年以上的肝肾功能、甘油三酯(TG)、总胆固醇(TC)、LDL-C和高密度脂蛋白胆固醇(HDL-C)水平,并计算LDL-C的达标率。结果 患者出院后1~3月、3~6个月、6~12个月及一年以上肝肾功能均无明显变化。出院后1~3个月、3~6个月、6~12个月、1年以上TG、TC水平无显著差异(P>0. 05);HDL-C水平略有差异(P=0. 047),分别为(1. 04±0. 18)mmol/L、(1. 15±0. 25) mmol/L、(1. 11±0. 21) mmol/L、(1. 11±0. 23) mmol/L;LDL-C的水平分别为(1. 97±0. 83)mmol/L、(1. 94±0. 69) mmol/L、(1. 88±0. 76) mmol/L、(2. 05±0. 55) mmol/L,差异具有统计学意义(P=0. 014);LDL-C的达标率分别为46. 3%、47. 8%、57. 2%、37. 6%,达标率在出院后6~12个月最高,1年后的达标率有下降趋势。结论 急性冠脉综合征经PCI治疗后患者的LDL-C的达标率还有待提高,长期的血脂管理需要加强。

Investigation of blood lipid status in patients with acute coronary syndrome after percutaneous coronary intervention reatment

Objective To investigate the level and the rate of low-density lipoprotein cholesterol(LDL-C)target contyol in patients with acute coronary syndrome(ACS)after percutaneous coronary intervention(PCI).Methods A retrospective study was carried out in 121 patients with ACS treated by PC in the coronary intervention clinic of Tiantan Hospital in July 2019.Statins were taken after discharge.The liver and kidney function,triglyceride(TG),total cholesterol(TC),LDL-C and high-density lipoprotein cholesterol(HDL-C)were recorded in 1-3 months,3-6 months,6-12 months and above 1 year after discharge,and the target control rate of LDL-C was calculated.Results There was no significant change in liver and renal function.There was no significant difference in TG and TC levels after discharge.The HDL-C was(1.04±0.18)mmol/L,(1.15±0.25)mmol/L,(1.11±0.21)mmol/L,(1.11±0.23)mmol/L,respectively,P=0.047;The LDL-C level was(1.97±0.83)mmol/L,(1.94±0.69)mmol/L,(1.88±0.76)mmol/L,(2.05±0.55)mmol/L in 1-3 months,3-6 months,6-12 months,above 1 year after discharge,respectively,with statistically significant difference(P=0.014).The LDL-C target control rates were 46.3%,47.8%,57.2%and 37.6%,respectively,the highest in 6-12 months after leaving hospital,but only 57.2%after one year,the control rate had a downward trend.Conclusion The LDL-C target control rate of patients with ACS after PCI needs to be improved,and the long-term blood lipid management needs to be strengthened.