特发性二尖瓣腱索断裂患者心血管病危险因素与冠状动脉造影结果的相关性分析  

Association of cardiovascular risk factors and coronary artery disease in patients with idiopathic ruptured mitral chordae tendineae

作　　者：罗晓亮[1] 张竞涛[1] 袁建松[1] 高晓津[1] 邱洪杨[1] 伟宪[1] 杨跃进[1] 乔树宾[1] 

机构地区：[1]中国医学科学院北京协和医学院阜外心血管病医院心血管病研究所心内科,北京100037

出　　处：《中国分子心脏病学杂志》2011年第6期321-323,共3页Molecular Cardiology of China

摘　　要：目的探讨特发性二尖瓣腱索断裂患者心血管病危险因素与冠状动脉(冠脉)造影结果的相关性。方法入选行冠脉造影的特发性二尖瓣腱索断裂患者195例,其中冠脉造影正常组143例(占74.33%),冠脉造影异常组(即确诊合并有冠心病)52例(占26.67%)。危险因素包括性别、年龄、吸烟史、高血压病、2型糖尿病、缺血性心血管病家族史、血脂异常、高尿酸血症、血红蛋白、总胆红素、体重指数。采用单因素和多因素分析。结果 (1)单因素分析显示,合并冠心病组发病年龄较冠脉造影正常组大,合并冠心病组吸烟比例、高血压病史比例、缺血性心血管病家族史比例、总胆固醇水平、甘油三酯水平、低密度脂蛋白胆固醇水平、尿酸水平均显著高于冠脉造影正常组。(2)多因素Logistic回归分析显示,缺血性心血管病家族史是特发性二尖瓣腱索断裂患者合并冠心病最显著的独立相关危险因素(OR=29.628,95%可信区间8.234-106.604,P=0.001),其它危险因素依次为高血压病史、高尿酸血症。结论缺血性心血管病家族史是特发性二尖瓣腱索断裂患者合并冠心病的独立相关危险因素,对于合并有冠心病高危因素(如高龄、有高血压病史、高尿酸、吸烟史、高脂血症)的特发性二尖瓣腱索断裂患者术前应完善冠脉造影检查,明确有无合并冠脉造影异常,以便制定合理手术方案。Objective To investigate the relationship between cardiovascular risk factors and coronary artery disease in patients with idiopathic ruptured mitral chordae tendineae. Methods To analyse the correlation between cardiovascular risk factors and coronary artery disease in 195 patients with idiopathic ruptured mitral chordae tendineae who underwent coronary angiography. Results (1) Fifty-two patients were diagnosed with coronary heart disease (CHD),and other 143 patients’ coronary vascular were normal. Patients with coronary heart disease had higher average age and higher level of total cholesterol(TC)、low density lipoprotein-cholesterol(LDL-C)、triglyceride(TG)、uric acid(UA) and higher incidence of combining with smoking、hypertension as well as family history of ischemic disease.(2)Logistic regression analysis showed that family history of ischemic disease was the prominent predictor of coronary heart disease(OR=29.628,95%CI 8.234-106.604,P=0.001).Other risk factors were hypertension and high uric acid level.Conclusions Family history of ischemic disease,hypertension and high uric acid level are independent correlative risk factors of coronary heart disease in patients with idiopathic ruptured mitral chordae tendineae . It is necessary for the elder patients in high risks in coronary heart disease to take a coronary angiography before cardiac operation.

关 键 词：特发性二尖瓣腱索断裂 冠状动脉疾病 冠状血管造影术 危险因素 

分 类 号：R541.4[医药卫生—心血管疾病]