Objective To investigate lipid-lowering drug use and blood lipid control in patients with coronary heart disease (CHD) according to gender,age and duration of CHD,and to analyze the risk factors influencing blood lipid control.Methods We performed a cross-sectional study enrolling a series of patients with previously diagnosed CHD who were outpatients or hospitalized at Tangshan Gongren Hospital between March 2015 and June 2016.We collected survey data on general demographic characteristics(sex,age),risk factors for CHD (including smoking,alcohol consumption and medical history of high blood pressure,diabetes and hyperlipidemia) and lipid-lowering drug use.Physical examinations of height,weight and blood pressure were performed.Early morning fasting blood samples were collected,and serum fasting blood glucose,glycosylated hemoglobin,total cholesterol,triglycerol (TG),high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) were measured using an automatic biochemical analyzer.Results A total of 581 questionnaires were issued,of which 542 were valid.Among them,175 patients(32.2%) were obese,126 patients (23.2%) were smokers,108 patients (19.9%) consumed alcohol,326 patients (60.1%) had high blood pressure and 102 patients (18.8%) had diabetes mellitus.A total of 348 patients (64.2%) had hyperlipoidemia,274 patients (50.5%)had hypercholesterolemia,226 patients(41.8%) had high blood TG levels,205 patients (37.9%) had low HDL-C and 294 patients(54.3%) had mixed hyperlipidemia.Fifty-five patients(10.2%) were taking lipid-lowering drugs.Male patients were more likely to be taking lipid-lowering drugs and had better LDL-C control than female patients(P<0.05).Patients <65 years old were more likely to be taking lipid-lowering drugs than patients ≥65 years old and had lower LDL-C(P<0.05).Patients with <5 years CHD duration were more likely to be using lipid-lowering drugs and were more likely to have attained their lipid goal than patients with CHD duration >5 years(P<0.05).Multivariate Logistic regression analysis results showed that gender, obese,diabetes and statin drug therapy were risk factors in lipid goal attainment (P<0.05).Conclusion Female CHD patients,patients aged 65 years or older and those with a CHD duration of 5 years or longer were less likely to be taking lipid-lowering drug treatment and more likely to have poor control of their blood lipid levels than male patients,patients <65 years of age and those with CHD history <5 years.Gender,obese,diabetes diagnosis and statin drug therapy were factors influencing blood lipid levels.%目的 调查不同性别、年龄及病程冠心病患者降脂药物服用和血脂水平控制情况,并分析血脂水平控制危险因素.方法 采用横断面调查法,选取2015年3月—2016年6月在唐山市工人医院心内科门诊或住院的冠心病患者.对患者进行面对面调查,调查内容包括一般人口学特征(性别、年龄);冠心病危险因素(吸烟、饮酒、高血压、糖尿病及高脂血症等病史);降脂药物服用情况;体格检查包括身高、体质量和血压等.清晨空腹采血,全自动生化分析仪测定血清空腹血糖、糖化血红蛋白、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)水平.结果 共发放问卷581份,有效问卷542份.其中肥胖175例(32.2%),吸烟126例(23.2%),饮酒108例(19.9%),高血压326例(60.1%),糖尿病102例(18.8%),高脂血症348例(64.2%),高TC血症274例(50.5%),高TG血脂226例(41.8%),低HDL-C血症205例(37.9%),混合型高脂血症294例(54.3%).55例(10.2%)正在服用降脂药物.男性患者降脂药物服用率及LDL-C血脂达标率均高于女性患者(P<0.05);年龄<65岁患者降脂药物服用率及LDL-C血脂达标率均高于≥65岁患者(P<0.05);冠心病病程<5年患者降脂药物服用率及LDL-C血脂达标率均高于病程≥5年患者(P<0.05).多因素Logistic回归分析结果显示,性别、肥胖、糖尿病及是否服用他汀类药物是影响血脂达标的因素(P<0.05).结论 女性、年龄≥65岁、病程≥5年的冠心病患者服用降脂药物的比例较低,血脂水平控制不佳;性别、肥胖、糖尿病及是否服用他汀类药物是血脂水平达标的影响因素.
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