摘要
目的分析心血管专科医院因胸痛就诊的患者中家族性高胆固醇血症（FH）的检出情况及临床特征。方法连续人选了2011年3月至2016年12月因胸痛就诊于阜外医院血脂中心行选择性冠状动脉造影检查的9908例患者，平均年龄为（56．6±11．1）岁，其中6782例（68．4％）为男性。按照荷兰临床脂质网络标准，将人选者分为FH组（271例）和非FH组（9637例），回顾性分析比较两组患者间血脂水平、冠心病患病情况及调脂治疗情况的差异。结果通过荷兰临床脂质网络标准，人选的患者中2．7％（271／9908）被诊断为FH。FH组中早发冠心病（指女性〈60岁，男性〈55岁）的比例占70．2％（201／271），非FH组中早发冠心病比例占44．5％（4287／9637），其差异有统计学意义（X2=93．738，P〈0．001）。FH组患者的总胆固醇（TO）、低密度脂蛋白胆同醇（LDL—C）水平高于非FH组[TC：（6．74±2．48）mmol／L比（4．15±1．10）mmol／L；LDL-C：（4．53±2．39）mmol／L比（2．52±0．97）mmol／L；t值分别为19．403、22．233，P均〈0．0011；此外，FH组中84．9％（230／271）的患者经过不同强度他汀药物调脂治疗，但是无l例患者LDL—C水平低于2．6mmol／L。结论中国人群FH患者检出率较低，其早发冠心病比例高，血脂水平高，但调脂治疗达标率低。因此，对FH患者需早期诊断及强化治疗。
Objectives To investigate the prevalence rate and clinical characteristics of familial hypercholesterolemia （FH） in Chinese patients undergoing coronary angiography due to angina-like chest pain. Methods From March 2011 to December 2016, a total of 9 908 consecutive patients undergoing coronary angiography in Fuwai Hospital due to angina-like chest pain were enrolled. The age of enrolled patients was （56.6±11.1） years old, and 6 782 cases （68.4%） were male. The patients were divided into two groups： FH group （n=271） and non-FH group （n=9 637）according to the Dutch Lipid Clinic Network diagnostic criteria. A retrospective analyze was performed on the baseline features between the two groups including lipids levels, coronary artery disease （CAD） characteristics, and lipids-lowering treatments. Results In the total cohort, the prevalence of definite/probable FH was 2.7% （271/9 908）. The incidence of premature coronary artery disease （PCAD） （women 〈 60 years old, or men 〈 55 years old） was higher in patients with FH than that in patients without FH （70.2%（201/271） vs. 44.5% （4 287/9 637）; X2=93.738, P〈 0.001）. Patients with FH had higher level of TC and LDL-C when compared with patients without FH （（6.74± 2.48） mmol/L vs. （4.15±1.10） mmol/L; （4.53＋-2.39） mmol/L vs. （2.52±0.97） retool/L; t=19.403, 22.233, P〈 0.001, respectively）. Additionally, 84.9% （230/271）of FH patients were treated with statin at different intensities, but none of them achieved the LDL-C〈2.6 mmol/L. Conclusions Chinese patients with familial hypereholesterolemia not only showed a high presence of PCAD and higher lipids levels, but also exhibited a low rate of achievement of low-density lipoprotein cholesterol targets despite statin theratiy. Our results thushighlight the importance of early diagnosis and intensive treatment of FH patients.
出处
《中华心血管病杂志》
CAS
CSCD
北大核心
2018年第2期104-108,共5页
Chinese Journal of Cardiology
基金
首都卫生发展科研专项（201614035）
医学与健康科技创新工程项目（2016-12M-1-011）
关键词
胸痛
家族性高胆固醇血症
血脂异常
早发冠心病
Chest pain
Familial hypercholesterolemia
Dyslipidemias
Premature coronaryartery disease
