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目的 探讨血脂水平对急性心肌梗死(AMI)患者近期预后的影响。方法 测定190例AMI患者入院时 的血清总胆固醇(Tc)、甘油三酯(TG)、高密度脂蛋白-胆固醇(HDL-c)、低密度脂蛋白-胆固醇(LDL-c)及计 算TG/HDL-c和LDL-c/HDL-c比值。并根据患者年龄、是否吸烟、有无并发糖尿病、高血压病进行分组,比较 各组间的血脂水平。同时分析AMI患者不同心功能分级及住院4周内死亡与血脂水平的关系。结果 心肌梗死 急性期Tc≥6.24mmol/L者占17%,4.68～6.24mmol/L者占47%,TG≥2.2mmol/L者占18%,1.70～2.2mmol/ L者占16%,LDL-c≥4.16mmol/L者占29%,2.6～4.16mmol/L者占50%,HDL-c<0.91mmol/L(男)占19%, HDL-c<1.17mmol/L(女)占33%,TG/HDL-c≥2.37%者占17%,LDL-c/HDL-c≥2.8者占53%。心功能 3～4级与心功能1～2级比较,住院4周内死亡者与生存者比较除TG外,其它各项血脂水平差异有显著性。结论 AMI患者急性期即可发现血脂异常,Tc、HDL-c、LDL-c及TG/HDL-c和LDL-c/HDL-c比值水平对 AMI患者近期预后有一定的影响,LDL-c/HDL-c比值作为AMI重要的决定治疗的指标。
Objective To investigate the effect of serum lipids on the short-term prognosis of patients with acute myocardial infarction (AMI). Methods The serum level of total cholesterol (Tc), triglyceride (TG), high density lipoprotein cholesterol (HDL-c) and low density lipoprotein cholesterol (LDL-c) HDL-c and LDL-c / HDL-c ratio. According to the patient’s age, whether smoking, with or without diabetes, hypertension were divided into groups, comparing the level of blood lipid among the groups. At the same time analysis of AMI patients with different cardiac function classification and hospitalization within 4 weeks of death and blood lipid levels. Results Tc≥6.24mmol / L in acute stage of myocardial infarction accounted for 17%, 4.68 ~ 6.24mmol / L in 47%, TG≥2.2mmol / L in 18%, 1.70 ~ 2.2mmol / L in 16%, LDL The patients with HDL-c <0.91mmol / L (male) accounted for 19%, HDL-c <1.17mmol / L 33% with TG / HDL-c≥2.37%, and 53% with LDL-c / HDL-c≥2.8. Heart function 3 to 4 levels compared with 1 to 2 cardiac function, hospitalized within 4 weeks of death compared with the survivors in addition to TG, the other blood lipid levels were significantly different. Conclusion The levels of Tc, HDL-c, LDL-c, TG / HDL-c and LDL-c / HDL-c in patients with acute myocardial infarction can be detected in acute phase of AMI. HDL-c ratio as an important indicator of the treatment of AMI.