目的: 探讨单中心就诊患儿血浆胆固醇水平异常情况及分布规律。方法: 回顾性分析2016年6月至2019年6月在北京大学第一医院有胆固醇检测结果的2~18岁儿童血浆胆固醇水平。总胆固醇(total cholesterol, TC)采用胆固醇氧化酶法,低密度脂蛋白胆固醇(low-density lipoprotein cholesterol, LDL-C)和高密度脂蛋白胆固醇(high-density lipoprotein cholesterol, HDL-C)采用清除法检测,计数资料比较应用卡方检验。结果: 调查有效数据11 829例,其中男性7 087例, 女性4 742例。TC升高儿童1 822例(15.4%), LDL-C升高儿童1 371例(11.6%),HDL-C降低儿童2 798例(23.7%), 胆固醇水平异常儿童总和4 427例(37.4%)。非常见继发性高脂血症病因就诊儿童7 835人,其中TC升高儿童731例(9.3%), LDL-C升高儿童561例(7.2%), HDL-C降低儿童1 886例(24.1%),胆固醇水平异常儿童总和2 576例(32.9%)。不同疾病就诊儿童中,胆固醇异常发生率差异有统计学意义(P<0.05)。TC升高及LDL-C升高发生率的前三位主要就诊原因均分别为“血脂异常”“泌尿系统疾病”“营养性疾病”。除小儿内科外,其他科室送检的1 257例患儿血脂检测样本中,300例存在胆固醇水平异常(23.8%), 其中高胆固醇血症患儿 70例(5.6%), 高低密度脂蛋白血症患儿44例(3.5%), 低高密度脂蛋白血症患儿224例(17.8%)。在非常见继发性高脂血症病因就诊儿童中,因LDL-C≥140 mg/dL (3.6 mmol/L) 需要进一步排除家族性高胆固醇血症的患儿共365例,占该部分患儿的4.6%。结论: 就诊儿童胆固醇异常发生率高,在原发病诊治的同时加强胆固醇管理不仅有助于控制继发性高胆固醇血症,也为及时发现家族性高胆固醇血症提供可能。

Objective: To investigate the abnormality and distribution of plasma cholesterol levels in single-center hospitalized children. Methods: The blood lipid levels of children aged 2-18 years who had blood lipid test results in Peking University First Hospital from June 2016 to June 2019 were etrospectively analyzed. Cholesterol oxidase method was used for total cholesterol, and high-density lipoprotein cholesterol and low-density lipoprotein cholesterol were detected by clearance method. The counting data were compared with chi-square test. Results: The survey had involved 11 829 children (7 087 were boys and 4 742 were girls). 1 822 (15.4%) children were with elevated total cholesterol, 1 371 (11.6%) children with elevated low-density lipoprotein cholesterol, and 2 798 (23.7%) children with high-density lipoprotein cholesterol reduction. The total number of the children with abnormal cholesterol levels was 4 427 (37.4%). Among the 7 835 children who visited hospital due to the disease not commonly inducing dyslipidemia, 731 (9.3%) had elevated TC, 561 (7.2%) had elevated LDL-C, 1 886 (24.1%) had decreased HDL-C, and 2 576 (32.9%) had abnormal cholesterol levels. Among the children with different diseases, the difference in the incidence of abnormal cholesterol was statistically significant. The top three main groups of the children with increased total cholesterol and low-density lipoprotein cholesterol were “dyslipidemia”, “urinary tract disease”, and “nutritional disease”; The top three main groups of the children with reduced high-density lipoprotein cholesterol were “respiratory diseases”, “dyslipidemia”, “hematological diseases and malignant tumors”. Among the 1 257 blood li-pid test results sent by other departments, 300 cases had abnormal cholesterol levels (23.8%). Among them, there were 70 children with hypercholesterolemia (5.6%), 44 children with increased low-density lipoprotein cholesterol (3.5%), and 224 children with reduced high-density lipoprotein cholesterol (17.8%). There were 365 (4.6%) children with low-density lipoprotein cholesterol ≥140 mg/dL (3.6 mmol/L) who needed to further exclude familiar hypercholesterolemia among the children who visited hospitals due to the disease not commonly inducing dyslipidemia. Conclusion: Children in hospitals have a high incidence of cholesterol abnormalities. Doctors need to pay more attention to the cholesterol diagnosis and management regardless of the discipline, which not only helps to control secondary hypercholesterolemia, but also provides the possibility of detecting familial hypercholesterolemia in time.