目的：调查老年冠心病患者血脂及二级预防用药情况,并分析二级预防用药对血脂控制情况的影响。方法：采用流行病学横断面研究方法选取我院2020年1月—2023年3月收治的老年冠心病患者,调查其一般资料、血脂情况以及二级预防用药情况等,并分析影响老年冠心病患者血脂控制的因素。结果：共入选536例老年冠心病患者,其中高胆固醇（total cholesterol,TC）血症265例（49.44%）,高甘油三酯（triacylglycerol,TG）血症207例（38.62%）,混合型高脂血症274例（51.12%）,低高密度脂蛋白胆固醇（High-density lipoprotein cholesterol,HDL-C）血症198例（36.94%）,血脂控制未达标354例（66.04%）,血脂控制达标182例（33.96%）;536例老年冠心病患者中,抗血小板药物、β受体阻滞剂、降脂类药物以及ACEI/ARB药物使用率分别为58.40%、51.49%、29.29%、49.63%;血脂控制未达标组和达标组冠心病病程、糖尿病史、他汀类降脂药物使用率、二级预防药物使用依从性、二级预防用药持续时间均差异显著;冠心病病程≥5年、糖尿病史以及未使用降脂药物、二级预防药物使用依从性差均是老年冠心病患者血脂控制未达标的独立危险因素,方差膨胀系数（variance inflation factor,VIF）均<3。结论：老年冠心病患者血脂异常情况较为常见,其血脂控制情况不容乐观,通过合理的二级预防用药干预尤其是规范使用他汀类降脂药物可以降低老年冠心病患者血脂水平,有利于其血脂达标。

Objective To investigate the status of blood lipids and secondary prophylactic medication in elderly patients with coronary heart disease, and analyze the influence of secondary prophylactic medication on blood lipid control. Methods An epidemiological cross-sectional study from January 2020 to March 2023 was conducted. The general information, blood lipids and secondary prophylactic medication of elderly patients with coronary heart disease admitted to the hospital were investigated to identify the factors affecting blood lipid control of elderly patients with coronary heart disease. Results A total of 536 elderly patients with coronary heart disease were enrolled, including 265(49.44%) patients with hypercholesterolemia, 207(38.62%) patients with hypertriglyceridemia, 274(51.12%) patients with mixed hyperlipidemia, 198(36.94%) patients with low HDL-C, 354(66.04%) patients with inadequately controlled blood lipids, and 182(33.96%) patients with standard blood lipid control. The proportions of patients treated with antiplatelet drugs, β-blockers, lipid-lowering drugs, and ACEI/ARB drugs were 58.40%, 51.49%, 29.29%, and 49.63%. There were significant differences between the inadequately controlled blood lipids group and the standard blood lipid control group in terms of the course of coronary heart disease, diabetes history, the usage rate of lipid-lowering statins, compliance with secondary prophylactic medication, and duration of secondary prophylactic medication. The course of coronary heart disease ≥5 years, diabetes history, no use of lipid-lowering drugs and poor compliance with secondary prophylactic medication were independent risk factors for blood lipid control failure in elderly patients with coronary heart disease. The variance inflation factor (VIF) was under 3. Conclusion Blood lipid abnormalities are common in elderly patients with coronary heart disease, and the status of blood lipid control is not optimistic. Reasonable secondary prophylactic medication, especially standard use of lipid-lowering statins, can lower blood lipid levels in elderly patients with coronary heart disease, which is conducive to obtaining standard blood lipids.