老年共病非瓣膜性房颤患者低密度脂蛋白胆固醇与HAS-BLED评分的相关性分析
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(中国医科大学附属盛京医院老年医学科,沈阳 110000)

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R541.7

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Correlation of LDL-C level and HAS-BLED score in elderly patients with comorbidities and non-valvular atrial fibrillation
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(Department of Geriatrics, Affiliated Shengjing Hospital of China Medical University, Shenyang 110000, China)

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    摘要:

    目的 探讨老年共病非瓣膜性房颤(AF)患者低密度脂蛋白胆固醇(LDL-C)水平与HAS-BLED评分的相关性,以期为降脂及抗凝治疗的临床决策提供新思路。方法 回顾性分析2013年1月至2016年12月期间中国医科大学附属盛京医院老年医学科住院的老年共病及多重用药CHA2DS2-VASc评分≥2分的患者139例,其中,男性85例,女性54例,年龄(78.9±8.2)岁。根据HAS-BLED分值分为出血低危组(HAS-BLED评分<3分,n=74)和出血高危组(HAS-BLED评分≥3分,n=65),比较两组患者共病和用药情况、血液生化指标以及分析HASB-LED评分与LDL-C水平的相关性。采用SPSS 22.0软件进行数据分析。根据数据类型分别采用t检验或χ2检验比较组间差异。二元logistic回归分析LDL-C水平与HAS-BLED评分的相关性。结果 相比出血低危组,出血高危组患者CHA2DS2-VASc评分、LDL-C水平、年龄、高血压及缺血性脑卒中患病率高,心力衰竭患病率低,差异有统计学意义(P<0.05)。校正对血脂水平及HAS-BLED评分有影响的混杂变量后,LDL-C(OR =2.066,95%CI 1.089~3.921;P=0.026)和年龄(OR=1.072,95%CI 1.011~1.137;P=0.02)与HASB-LED评分呈显著正相关。结论 CHA2DS2-VASc≥2分的老年共病非瓣膜性AF患者,LDL-C水平和年龄增长可能导致出血风险增高,建议应密切关注该人群LDL-C水平。

    Abstract:

    Objective To investigate the correlation between low-density lipoprotein cholesterol (LDL-C) level and HAS-BLED score in elderly patients with comorbidities and non-valvular atrial fibrillation (AF), in order to provide new thoughts for clinical decision-making in lipid-lowering and anticoagulation therapy. Methods A retrospective analysis was carried out on 139 elderly patients with comorbidities and non-valvular AF, and CHA2DS2-VASc score ≥2 hospitalized in our department from January 2013 to December 2016. They were 85 males and 54 females, at an age of(78.9±8.2) years, and were divided into low-bleeding-risk group (HAS-BLED <3, n=74) and high-bleeding-risk group (HAS-BLED ≥3, n=65). Clinical features of comorbidities and poly-pharmacy and laboratory biochemical indices were compared between the 2 groups. The correlation of LDL-C level and HAS-BLED score was analyzed. Clinical data were analyzed by SPSS statistics 22.0. The differences were compared with t test or Chi-square test respectively. Binary logistic regression analysis was adopted for the correlation of LDL-C level and HAS-BLED score. Results The high-bleeding-risk group had significantly higher CHA2DS2-VASc score and LDL-C level, older age, and larger proportions of hypertension and ischemic cerebral stroke, but smaller proportion of heart failure when compared with the low-bleeding-risk group (P<0.05). After adjustment of many confounding factors for lipids level and HAS-BLED score, LDL-C level (OR=2.066,5%CI 1.089-3.921,P=0.026) and age (OR=1.072,5%CI 1.011-1.137, P=0.02) were positively correlated with HAS-BLED score. Conclusion For elder patients with comorbidities, and CHA2DS2-VASc score ≥2 non-valvular AF, higher LDL-C level and older age may increase the risk for bleeding events. So, LDL-C level should be closely monitored for such patients.

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曹志明,白小涓,韩璐璐.老年共病非瓣膜性房颤患者低密度脂蛋白胆固醇与HAS-BLED评分的相关性分析[J].中华老年多器官疾病杂志,2017,16(9):663~667

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  • 收稿日期:2017-03-15
  • 最后修改日期:2017-04-20
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  • 在线发布日期: 2017-09-26
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