【摘要】 目的探讨老年人随访LDL-C变异性与动脉粥样硬化的相关性。方法选择山东省济南市章丘区合格入选老年人667例,平均随访6年。每次年度随访时检测血浆LDL-C及高敏C反应蛋白(hs-CRP),并计算LDL-C变异性。根据LDL-C标准差三分位(<0.42mmol/L,0.42～0.63mmol/L,>0.63mmol/L)分为低变异性组221例,中变异性组224例和高变异性组222例。颈动脉内膜中层厚度(IMT)及颈股脉搏波传导速度(cfPWV)每2年检测1次。结果与低变异性组比较,中变异性组及高变异性组颈动脉IMT、cfPWV及hs-CRP变化值明显升高,差异有统计学意义(P<0.05)。与中变异性组比较,高变异性组颈动脉IMT、cfPWV及hs-CRP变化值明显升高,差异有统计学意义(P<0.05)。Pearson相关性分析显示,随访LDL-C变异性与颈动脉IMT、cfPWV及hs-CRP变化值呈正相关(r=0.407,r=0.314,r=0.303,P<0.01)。校正混杂因素后,随访LDL-C变异性是颈动脉IMT、cfPWV及hs-CRP升高的独立危险因素(P<0.01)。结论高随访LDL-C变异性是老年人动脉粥样硬化的重要危险因素,并独立于LDL-C水平及调脂治疗。更多还原

【Abstract】 Objective To study the association between visit to visit LDL-C variability and progressive atherosclerosis in the elderly.Methods Six hundred and sixty-seven elderly persons were followed up for an average period of 6 years,during which their serum LDL-C and hs-CRP levels were measured and their LDL-C variability was calculated at each annual follow-up.The elderly persons were divided into LDL-C<0.42 mmol/L group(n=221),LDL-C=0.42-0.63 mmol/L group(n=224),and LDL-C>0.63 mmol/L group(n=222).Their carotid artery IMT and cfPWV were measured every two years.Results The carodtid artery IMT was significantly thicker,the cfPWV was significantly faster,the serum hs-CRP level was significantly higher in LDL-C=0.42-0.63 mmol/L group and LDL-C>0.63 mmol/L group than in LDL-C<0.42 mmol/L group(P<0.05)and in LDL-C<0.42 mmol/L group than in LDL-C=0.42-0.63 mmol/L group(P<0.05).Pearson correlation analysis showed that the visit to visit LDL-C variability was positively associated with the carodtid artery IMT,cfPWV and serum hs-CRP level(r=0.407,r=0.314,r=0.303,P<0.01).The visit to visit LDL-C variability was an independent risk factor for elevated carodtid artery IMT,cfPWV and serum hs-CRP level after adjustment for confunders(P<0.01).Conclusion Elevated visit to visit LDL-C variability,independent of the serum LDL-C level and anti-lipid treatment,is an important risk factor for progressive atherosclerosis in elderly persons.更多还原