代谢综合征患者冠状动脉病变特点及相关危险因素的探讨  

Relationship between metbolic syndrome and severity of coronary heart disease

作　　者：杨成明[1] 王旭开[1] 曾春雨[1] 王红勇[1] 刘光耀[1] 方玉强[1] 傅春江[1] 石伟彬[1] 张晔[1] 

机构地区：[1]第三军医大学大坪医院野战外科研究所心内科,重庆400042

出　　处：《重庆医学》2008年第6期588-589,共2页Chongqing medicine

摘　　要：目的探讨代谢综合征(metabolic syndrome,MS)患者冠状动脉病变特点及相关危险因素。方法纳入作冠脉造影的患者654例,所有患者均查体重指数、腹围、非同日血压、血脂、空腹及餐后2h血糖。冠状动脉的狭窄程度用造影图像处理系统测量,根据病变损害的程度评分。冠状动脉狭窄大于或等于50%诊断为冠心病(coronaryartery disease,CAD)425例,其中129例合并MS(冠心病合并MS组),296例不合并MS(对照组)。结果冠脉造影患者中冠心病合并MS的患病率为30.4%(129/425),与对照组相比较,甘油三酯(triglyeride,TG)、高密度脂蛋白胆固醇(high density lipoprotein cholesterol,HDL-C)的差异有统计学意义(P<0.05)。冠心病合并MS组高血糖、高血压、肥胖患病率显著高于对照组;MS组的冠状动脉造影主要表现为3支血管病变或多支多节段血管病变,病变率分别为51.2%、30.9%,明显较不合并MS组的情况严重。偏相关分析排除其他易患因素,如年龄、吸烟量的影响后,仍示MS的严重情况与冠状动脉血管狭窄程度有显著的相关性。而且,无论是病情的严重程度,还是需要血运重建的患者数都显著高于不合并MS组。结论MS可作为冠状动脉狭窄严重程度的参考指标之一。全面干预MS的各个成分,对冠心病的防治具有重要临床意义。Objective To study the angiographical characteristics of coronary heart disease （CHD） and correlational risk factors in the patients with metabolic syndrome （MS）. Methods Six hundred and fifty-four patients who underwent coronary angiography were recruited in this study. The Patients with coronary stenosis ≥ 50% were involved in the group of coronary heart disease （CHD）. Coronary arterial stenosis was measured by the image manipulation system of angiography. The severity of CHD was quantified by a modified Gensini score. The relationship between MS and coronary stenosis severity in CHD was analysed. Results The patients with MS had a higher incidence of CHD and more severe stenosis of the coronary arteries than those without. Partial correlation statistics analysis showed that there was a positive correlation between the stage of MS and the grade of coronary arterial stenosis severity, Conclusion MS may be one of the predictor of severity of coronary arterial stenosis in CHD. All measures involved in intervention to the components of MS are contributive to the prevention and treatment of coronary heart disease.

关 键 词：代谢综合征 冠状动脉造影 冠心病 

分 类 号：R589[医药卫生—内分泌] R543[医药卫生—内科学]