早发冠心病的高血压患者危险因素分析  

An analysis of the risk factors for premature coronary heart disease in patients with primary hypertension

作　　者：车京津[1] 张承宗[1] 牛海芳[1] 邵元霞[1] 

机构地区：[1]天津医科大学第二医院心内科,300211

出　　处：《中华临床医师杂志（电子版）》2011年第23期6892-6897,共6页Chinese Journal of Clinicians(Electronic Edition)

摘　　要：目的探讨早发冠状动脉粥样硬化性心脏病(简称冠心病)的高血压患者传统冠心病危险因子的流行病学特点。方法对比冠状动脉造影证实的267例合并早发冠心病的高血压患者(病变组)与96例冠状动脉正常的高血压患者的临床资料和实验室检查结果,分析其中主要心血管危险因素。结果病变组比正常组的男性、早发冠心病家族史、糖尿病、吸烟、饮酒比例显著增高,且在体重指数、甘油三酯、极低密度脂蛋白胆固醇、尿素氮、尿酸、白细胞计数和C反应蛋白水平上显著增高,但高密度脂蛋白胆固醇水平较低(P<0.05)。多元Logistic回归分析表明,早发冠心病家族史、低高密度脂蛋白胆固醇血症、高甘油三酯血症、糖尿病年数、性别对早发冠心病有显著的预测价值,OR值分别为12.317、3.267、2.894、1.140、0.088。结论低高密度脂蛋白胆固醇血症和高甘油三酯血症是我国汉族人群年轻高血压患者出现早发冠心病的重要的可控危险因素。Objective To investigate the epidemiological characteristic of conventional risk factors of premature coronary heart disease(CHD) in patients with primary hypertension.Methods Data of 267 hypertensive patients with premature CHD(CHD group) and 96 hypertensive patients without any coronary disease were compared.The potent coronary risk factors were analyzed by logistic regression.Results The CHD group had higher ratios of male gender,premature family history(PFH),diabetes mellitus(DM),smoking,drinking alcohol,and higher levels of body mass index(BMI),triglyceride(TG),very low-density lipoproteins cholesterols(VLDL-C),blood urea nitrogen(BUN),uric acid(UA),white blood cells(WBC),and C-reactive protein(CRP),but lower levels of high-density lipoprotein cholesterols(HDL-C)(P<0.05).Multivariate logistic analysis showed PFH,low HDL-cholesterolemia,hypertriglyceridemia,duration of DM,male gender were significantly associated with premature CHD(P<0.05),with OR of 12.317,3.267,2.894,1.140,0.088,respectively.Conclusions Low HDL-cholesterolemia and hypertriglyceridemia are importantly controllable coronary risk factors for young Chinese people with hypertension.

关 键 词：高血压 冠心病 高甘油三酯血症 胆固醇 HDL 

分 类 号：R541.4[医药卫生—心血管疾病]