目的 探讨非空腹血脂检测在住院人群中应用的可行性.方法 自身对照研究.连续入选2015年4月至2016年10月北京阜外医院血脂中心住院患者608例,年龄20~86岁.分别采集患者的空腹和早餐后1~4 h血液样本,同时测定血浆三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)和低密度脂蛋白胆固醇(LDL-C)水平,两次检测的结果采用Wilcoxon符号秩检验法进行对比.结果 与空腹相比,非空腹TG升高0.47 mmol/L(30%),HDL-C降低0.03 mmol/L(2.8%),LDL-C降低0.09 mmol/L(3%),LDL-C(公式法)降低0.24 mmol/L(8.7%),差异均有统计学意义(P<0.001).而TC升高0.01 mmol/L和非HDL-C升高0.02 mmol/L,非空腹与空腹检测之间差异无统计学意义.对TG水平进行分层,当TG>4.5 mmol/L时,非空腹LDL-C水平在直接测定法中下降程度与总体差异不大(0.07 vs. 0.09),而在公式法中下降明显(0.66 vs. 0.24),下降程度34.9% vs. 8.7%.结论 非空腹血脂检测可以作为住院患者常规血脂谱的评价方法.
Objective To explore the feasibility of the application of non fasting blood lipid in the hospitalized population.Methods Self-control study was used.608 patients(aged 20~86 years old) were enrolled from April 2015 to October 2016 in lipid center of FuWai hospital.Fasting sample and non-fasting sample(1~4 h after breakfast) were collected from every patient and lipid profile including TG (triglyceride), TC (total cholesterol), HDL-C (high density lipoprotein cholesterol) and LDL-C (low density lipoprotein cholesterol) were measured in clinical laboratory.The results of two tests were compared using the Wilcoxon signed-rank test.Results The differences between non-fasting and fasting lipid test were +0.47 mmol/l (+30%) for TG,-0.03 mmol/l (-2.8%) for HDL-C,-0.09 mmol/l (-3%) for LDL-C and-0.24 mmol/l (-8.7%) for calculated LDL-C (P<0.001 respectively).The differenceswere +0.01 mmol/l for TC and +0.02 mmol/l for non-HDL-C,therefore no statistical difference was observed.When the TG level was stratified,the level of non-fasting LDL-C using directing test method was not significantly different between TG> 4.5 mmol/L and the whole (0.07 vs.0.09),but the level of non-fasting LDL-C using formula method wassignificantly different between TG> 4.5 mmol/L and the whole (0.66 Vs.0.24),andthe drops were 34.9% vs.8.7%.Conclusion Non-fasting lipid test could be an effective routine method for lipid evaluation in the hospitalized population.