Анализ частоты выявления гиперхолестеринемии, атеросклероза сонных артерий и назначения гиполипидемической терапии у лиц молодого возраста до 45 лет по данным регистра Duplex
Авторы
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Олег В. Гайсенок
Объединенная больница с поликлиникой
https://orcid.org/0000-0002-2379-0450
DOI:
https://doi.org/10.18413/rrpharmacology.9.10007Аннотация
Цель исследования проанализировать выявление гиперхолестеринемии (ГХС) и атеросклероза сонных артерий (АСА), верифицированных с помощью дуплексного сканирования сонных артерий (ДССА) у лиц молодого возраста (МВ), и оценить назначение гиполипидемической терапии (ГЛТ) по базе данных местного реестра.
Материалы и методы. В данном исследовании использовалась база данных регистра Duplex(n=2548). Для окончательного анализа были отобраны молодые люди в возрасте до 45 лет (n=351).
Результаты. ГХС (> 5 ммоль/л) выявлен у 68,9% больных (n=241), из них только 9,5% получали ГЛТ (n=23). АСА выявлен у 12,8% (n=45), из них только 17,8% получали ГЛТ (n=8). Мужчины и женщины различались по частоте АСА в этом возрастном диапазоне в 1,5 раза: 15,7% (30 из 191) и 9,4% (15 из 160), р=0,05. Мужчины также в целом имеют более высокую распространенность других факторов риска/заболеваний: ГХС (78,0% (n=149) против 58,1% (n=93) у женщин, p=0,00004), артериальной гипертензии (АГ) (15,7% (n=30)). ) vs 9,4% (n=15) у женщин, p=0,05), инфаркт миокарда (ИМ) в анамнезе (1,6% (n=3) vs 0% (n=0) у женщин, нс). Признаки, которые оказали значительное влияние на потребление ГЛТ, были следующими: АСА (OR 2,8 [1,09; 6,6] p = 0,036); АГ (ОШ 3,1 [1,32; 7,16] р=0,009); ГХС (> 5 ммоль/л) (ОШ 4,2 [1,12; 26,83] р=0,06); ГХС (МКБ-10, код Е78) (ОШ 5,4 [2,04; 13,7] р=0,0003); ИМ в анамнезе (ОШ 22,3 [1,65;675,5] р=0,009).
Заключение. В настоящем исследовании была установлена недостаточность назначения ГЛТ у молодых людей с ГХС и АСА. Использование методов визуализации для уточнения степени сердечно-сосудистого риска целесообразно у пациентов низкого и среднего риска, к которым относятся лица молодого возраста. ДССА является основным методом верификации субклинического атеросклероза. ГЛТ следует назначать всем больным МВ с САС (при отсутствии противопоказаний).
Графическая аннотация
Графическая аннотация
Ключевые слова:
гиполипидемическая терапия, молодые люди, гиперхолестеринемия, атеросклероз сонных артерий, дуплексное сканирование, регистрБиблиографические ссылки
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