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Apparent protective effect of high density lipoprotein against coronary heart disease in the elderly

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Author:: No author available

Journal Title:: NATIONAL MEDICAL JOURNAL OF CHINA

Issue:: 10

DOI:: 10.3760/j:issn:0376-2491.2003.10.006

Key Word:: 老年;高密度脂蛋白;心肌梗死;冠心病;长期随访

Abstract：目的分析高密度脂蛋白胆固醇(HDL-C)水平与急性心肌梗死(AMI)及冠心病(CHD)死亡的关系,及高HDL水平对CHD的保护作用.方法长期随访1 211例老年离休干部,平均年龄入组时为70±9岁,终点80±9岁.随访时间为1986～2000年,平均随访11.2年.按HDL-C水平分为低(<1.03 mmol/L)中 (正常, 1.03～1.56 mmol/L)及高 (>1.56 mmol/L)3组,比较各组中AMI事件及CHD死亡率的差异.结果随访期间累计发生CHD事件(大都为AMI)214例,其中死亡89例,其他原因死亡308例.HDL-C从低水平组升至正常水平组时,AMI减少40%,CHD死亡减少53%;从正常水平组升至高水平组时,AMI减少56%,CHD死亡减少50%.单独将血脂正常(总胆固醇<5.17 mmol/L、甘油三酯<1.69 mmol/L)的病例(411例)做统计分析,虽然低HDL-C的致病作用仍很明显,但HDL-C在正常与高水平时,发病与死亡数减少极明显.结论对于老年人的AMI发病和CHD死亡,低HDL-C仍是明显的独立危险因素,高HDL-C水平对冠状动脉病的保护作用极为显著.在血脂不高的情况下,HDL对冠状动脉的保护作用更强.

Reference

[1]李健斋,陈文祥,王抒,等.血脂水平在长时期内的生物学变异[J].2003,(1).
[2]李健斋,陈曼丽,王抒,等.老年人血脂与冠心病的长期随访研究[J].2002,(11).
[3]李健斋,王新德.脑血管病患者高密度度脂蛋白降低及其意义[J].1990,070 (5).
[4]Fye CL,Rubins HB,Anderson JW,etc.Gemfibrozil for the secondary prevention of coronary heart disease in men with low levels of high-density lipoprotein cholesterol. Veterans Affairs High-Density Lipoprotein Cholesterol Intervention Trial Study Group.[J].1999,341(6).
[5]李健斋,王抒,何青,等.正常（或低）胆固醇冠心病患者的脂蛋白谱特点[J].1997,(4).
[6]U, Goldbourt,S, Yaari,J H, Medalie.Isolated low HDL cholesterol as a risk factor for coronary heart disease mortality. A 21-year follow-up of 8000 men.[J].1997,17.
[7]Kargman DE,Benson RT,Boden-Albala B,etc.High-density lipoprotein cholesterol and ischemic stroke in the elderly: the Northern Manhattan Stroke Study.[J].2001,285(21).
[8]李健斋,牛庆田.衰老进程中血脂，脂蛋白与载脂蛋白的变化[J].1990,009 (4).
[9]Zongli W,Mingpeng S.The protective role of high-density lipoproteins in atherosclerosis.[J].1999,34(4).
[10]Hanna Bloomfield Rubins,Sander J. Robins,Dorothea Collins,etc.Distribution of lipids in 8,500 men with coronary artery disease[J].1995,75(17).
[11]Frick, M.H.,Elo, O..Helsinki heart study:...[J].1987,317(20).
[12].Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III).[J].2001,285(19).
[13]D J, Maron.The epidemiology of low levels of high-density lipoprotein cholesterol in patients with and without coronary artery disease.[J].2000,86(12A).
[14]Assmann G,von-Eckardstein A.Prevention of coronary heart disease by raising high-density lipoprotein cholesterol?[J].2000,11(6).
[15]Schmitz G,Langmann T.Structure, function and regulation of the ABC1 gene product.[J].2001,12(2).
[16]J Z, Li,P Y, Li,Q T, Niu,etc.Serum-lipid and lipoprotein patterns of Beijing populations from birth to senescence.[J].1988,101.
[17]C L, Johnson,B M, Rifkind,C T, Sempos,etc.Declining serum total cholesterol levels among US adults. The National Health and Nutrition Examination Surveys.[J].1993,269(23).