朱文奎 季蓉蓉 陈洁

摘 要 目的：探讨社区老年血脂异常的血栓弹力图指标与血脂的关系。方法：选取2020年7月至10月在沪东社区卫生服务中心进行检查的408例老年居民，其中血脂异常患者208例和血脂正常者200例。血脂异常者的平均年龄为（72.29±8.51）岁，其中男性98例（47.12%），女性110例（52.88%）；血脂正常者的平均年龄为（70.10±9.20）岁，其中男性95例（47.50%），女性105例（52.5%）。采集空腹静脉血测定两组对象的血栓弹力图，比较两组间血栓弹力图指标的差异，分析血栓弹力指标与血脂指标的相关性。结果：两组对象的年齡、K值、Angle值、MA值差异均无统计学意义（P>0.05）。血脂异常组患者的R值低于血脂正常组，CI值高于血脂正常组，差异均有统计学意义（P<0.05）。Spearman相关分析结果显示，R值与低密度脂蛋白胆固醇（LDL-c）成负相关（P<0.05），MA值和CI值均与总胆固醇（TC）、LDL-c成正相关（P<0.05）。Logistic回归分析显示，Angle值是血脂异常的危险因素（OR=2.90，95%CI为1.18～7.12）。结论：血脂异常患者血栓弹力图的R值降低、CI值增高，老年血脂异常患者的血脂水平与体内凝血状态相关。

关键词 血脂异常；老年人；血栓弹力图

中图分类号：R589.2 文献标志码：A 文章编号：1006-1533（2021）12-0052-03

Study of the relationship between elderly dyslipidemia and thromboelastography in the community

ZHU Wenkui， JI Rongrong， CHEN Jie

（Clinical Laboratory of Hudong Community Health Service Center of Pudong New District， Shanghai 200129， China）

ABSTRACT Objective： To explore the relationship between the thromboelastogram indexes and blood lipid indexes in the elderly patients with dyslipidemia in the community. Methods： Four hundred and eight elderly residents who were examined in Hudong Community Health Service Center from July to October 2020 were selected， among them， there were 208 patients with dyslipidemia and 200 patients with normal blood lipid. The average age of patients with dyslipidemia was （72.29±8.51） years old， including 98 males（47.12%） and 110 females（52.88%）； the average age of people with normal blood lipid was（70.10±9.20） years old， including 95 males（47.50%） and 105 females（52.5%）. Fasting venous blood was collected to determine the thromboelastogram of the two groups of subjects to compare the differences in thromboelastogram indicators between the two groups， and to analyze the correlation between thromboelastic indicators and blood lipid indicators. Results： There were no statistically significant differences in age， K value， Angle value， and MA value between the two groups of the subjects（P>0.05）. The R value of the dyslipidemia group was lower than that of the normal blood lipid group， and the CI value of the dyslipidemia group was higher than that of the normal blood lipid group and the differences were statistically significant（P<0.05）. Spearman correlation analysis showed that the R value was negatively correlated with low-density lipoprotein cholesterol （LDL-c）（P<0.05）， and both MA and CI values were positively correlated with total cholesterol （TC） and LDL-c（P<0.05） ）. Logistic regression analysis showed that Angle value was a risk factor for dyslipidemia（OR =2.90， 95% CI： 1.18-7.12）. Conclusion： In patients with dyslipidemia， the R value of the thromboelastogram decreases and the CI value increases， and the blood lipid level of the elderly patients with dyslipidemia is related to the coagulation status in the body.

KEY WORDS dyslipidemia； elderly people； thromboelastogram

随着社会经济的发展，中国人群的饮食结构和生活方式发生了很大的改变，血脂异常的患病率已达到40.40%[1]。血脂异常是心血管病事件的重要危险因素之一，可增加心脑血管疾病的发病率和死亡率[2]。有研究表明，心血管疾病的早期就与血栓具有相关性。在心血管疾病发展过程中，凝血酶的大量产生促使凝血功能发生改变[3]。血栓弹力图（thromboelastography，TEG）是通过体外模拟体内凝血和纤溶的全过程来检测血液凝固性，是监测血栓状态的一种新方法[4]，近年来得到广泛的应用。但对血脂代谢紊乱患者体内的血栓状态报道较少。本研究旨在分析老年血脂异常患者的TEG情况，为预防心血管疾病和早期发生血栓提供实验室依据。

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