摘要
目的 本研究旨在探究老年原发性高血压患者低密度脂蛋白胆固醇(LDL-C)、残余胆固醇(RC)与心血管事件发生的关系研究.方法 选取 138 例门诊老年原发性高血压患者,根据是否发生心血管不良事件,将高血压患者分为发生组 32例和未发生组 106 例.分别比较两组患者的一般资料、入院血清TC、HDL-C、LDL-C、RC水平、神经功能评分(NHISS),采用ROC曲线分析上述指标水平对原发性高血压患者心血管事件发生的预测价值.结果 发生组和未发生组患者的病程、饮食习惯、血压水平、高血压Ⅱ～Ⅲ级、冠心病家族史比较,差异无统计学意义(P>0.05);发生组的血脂水平TC、HDL-C、RC较未发生组患者高,LDL-C较未发生组低,差异有统计学意义(P<0.05);发生组的心功能左心室舒张末内径(LVDD)、左心室收缩末内径(LVSD)较未发生组高,左心室射血分数(LVEF)较未发生组低,差异有统计学意义(P<0.05);血脂TC、HDL-C、LDL-C、RC水平预测患者心血管事件的ROC曲线下面积(Area Under Curve,AUC)分别为 0.693、0.694、0.754、0.769,敏感度分别为68.75%、62.50%、78.12%、62.50%,特异度为 68.87%、73.58%、64.15%、88.68%,差异有统计学意义(P<0.05).结论 TC、HDL-C、LDL-C和RC水平与老年原发性高血压病人发生心血管事件相关,并可用于评估其潜在的心血管疾病危险.
Abstract
Objective This study aims to explore the relationship between low-density lipoprotein cholesterol(LDL-C),residual cholesterol(RC)and cardiovascular events in elderly patients with essential hypertension.Methods 138 elderly essen-tial hypertension patients were divided into 32 cases and 106 cases according to the occurrence of adverse cardiovascular events.The general data,admission serum TC,HDL-C,LDL-C,RC level,and neurological function score(NHISS)were compared between the two groups,and the ROC curve was used to analyze the prediction value of the above index level of cardiovas-cular events in patients with essential hypertension.Results Comparison of disease duration,dietary habits,blood pressure level,hypertension grades Ⅱ-Ⅲ,family history of CAD in the incident and no incident group,The difference was statistically significant(P<0.05);High lipid levels TC,HDL-C,and RC in the incident group compared with patients in the naive group,LDL-C was lower than that in the untreated group,The difference was statistically significant(P<0.05);Higher left ventricular end diastolic internal diameter(LVDD),left ventricular systolic end internal diameter(LVSD)than the occurrence group,Low left ventricular ejection fraction(LVEF)than in the untreated group,The difference was statistically significant(P<0.05);Area under the ROC curve of serum lipid TC,HDL-C,LDL-C,and RC levels for predicting cardiovascular events in patients(Area Under Curve,AUC)were 0.693,0.694,0.754,and 0.769,respectively,Sensitivity was 68.75%,62.50%,78.12%,and 62.50%,re-spectively,Specific was 68.87%,73.58%,64.15%,88.68%,The difference was statistically significant(P<0.05).Conclusions TC,HDL-C,LDL-C and RC levels are associated with cardiovascular events in elderly patients with essential hypertension and can be used to assess potential cardiovascular disease risk.
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