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目的 研究90岁以上长寿干部人群血脂代谢特点及临床意义.方法 选取90岁以上住院干部105名作为长寿组,60～80岁住院干部85名作为普通组.应用两独立样本t检验、秩和检验以及卡方检验的方法,对两组人员的总胆同醇(TC),三酰甘油(TG),低密度脂蛋白胆固醇(LDL-C),高密度脂蛋白胆固醇(HDL-C),载脂蛋白-A1(apoA-I),载脂蛋白B(apoB),脂蛋白a[Lp(a)]以及体质指数(BMI)等各项指标的水平进行比较.同时比较两组间基础疾病患病情况和应用降脂药物的情况.结果 长寿组的TC、TG、LDL-C、apoB和NHDL-C水平均较普通组显著偏低[3.90±0.89 vs4.36±1.06;0.89(0.57)vs 1.16(0.69);2.35 ±0.72 vs 2.70±0.88;0.68±0.19 vs 0.75±0.22;2.69±0.79 vs 3.18±1.00],HDL-C/TC、HDL-C/LDL-C显著高于普通组[0.32±0.084 vs 0.28±0.082；0.52(0.22)vs 0.43(0.28)].长寿组Lp(a)水平高于普通组,无统计学意义.长寿组体质指数明显低于普通组.长寿组中至少合并存在高血压,糖尿病,高脂血症,超重或肥胖四项中三项的人数比例明显低于普通组(24.8％vs 43.5％),差别主要来源于血脂水平以及体质指数的差异.结论 90岁以上干部人群血脂整体水平偏低,但血脂中代表抗动脉粥样硬化成分的比例(HDL-C/TC,HDL-C/LDL-C)较普通组显著偏高；长寿组同时合并高血压、糖尿病、高脂血症、超重或肥胖的人群明显少于普通组,差异主要来源于血脂以及体重,而这两方面均是可以控制和改变的危险因素.

Objective To study the characteristics of serum lipid metabolism in cadres aged 90 and above.Methods A total of 105 in-patient cadres aged 90 and above were assigned to the longevity group,and another 85 in-patient cadres aged 60 to 80 years were used as controls.Medical history of the participants were retrospectively reviewed,and serum levels of total cholesterol(TC),triglyceride(TG),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),apoB,apoA-I,Lp(a)and body mass index(BMI)were tested.Results Compared with the control group,TC,TG,LDL-C,apoB and non-HDL-C were significantly decreased in the longevity group[3.90 +0.89 vs 4.36 ± 1.06,0.89(0.57)vs 1.16(0.69),2.35 ±0.72 vs 2.70 ±0.88,0.68 ±0.19 vs 0.75 ±0.22,2.69 ±0.79 vs 3.18 ± 1.00,respectively].However,HDL-C/TC and HDL-C/LDL-C were significantly increased in the longevity group [0.32 ±0.084 vs 0.28 ±0.082,0.52(0.22)vs 0.43(0.28),respectively].Lp(a)of the longevity group was higher than that of the control group,although no statistically significant difference was found.BMI of the longevity group was significantly lower than that of the control group.In the longevity group,the percentage of individual who were combined with hypertension,hyperglycemia,hyperlipidemia and overweight/fat was lower (24.8％ vs 43.5％).Conclusions Serum lipid level is relatively lower in cadres aged 90 and above,and those who are combined with hypertension,hyperglycemia,hyperlipidemia and overweight/fat are significantly lower in this populations.