冠心病合并代谢综合征患者冠状动脉病变相关因素的临床研究  

Clinical research on correlated factors of coronary artery impairment in coronary heart disease patients with metabolic syndrome

作　　者：奚耀[1] 钱义明[1] 项志兵[1] 顾晓刚[2] 巫亚颖[1] 王进[1] 

机构地区：[1]上海中医药大学附属岳阳中西医结合医院急诊部,上海200437 [2]上海中医药大学附属岳阳中西医结合医院检验科

出　　处：《中国急救医学》2009年第6期491-495,共5页Chinese Journal of Critical Care Medicine

摘　　要：目的探讨冠心病（CAD）合并代谢综合征（MS）患者冠状动脉粥样硬化病变程度与相关危险因素之间的联系，并研究CAD合并MS患者体质量指数（BMI）与冠状动脉病变程度的相关性。方法回顾性分析179例经冠状动脉造影确诊为CAD的患者，分为MS组（99例）和非MS组（80例），比较二组患者的冠状动脉Gensini评分及程度、左心室射血分数（LVEF）、血压、BMI、空腹及餐后2h血糖、血脂、纤维蛋白原（FIB）、脑钠肽（BNP）、超敏C反应蛋白（hs—CRP）。同时根据MS患者的BMl分为重度MS组（52例）和轻度MS组（47例），比较二组患者的冠状动脉Gensini评分及病变程度、LVEF、血压、BMI、空腹及餐后2h血糖、血脂、FIB、BNP、hs—CRP。结果MS组冠状动脉Gensini评分及病变程度、LVEF、血压、BMI、空腹及餐后2h血糖、血脂、FIB、BNP和hs—CRP与非MS组比较差异有统计学意义（P〈0．05或P〈0．01）；重度MS组冠状动脉Gensini评分及病变程度、BMI、总胆固醇、甘油三酯、高密度脂蛋白、FIB、BNP、hs—CRP与轻度MS组比较差异有统计学意义（P〈0．05或P〈0．01）；相关回归分析显示，重度MS患者冠状动脉病变程度与BMI存在正相关关系。结论CAD合并MS患者冠状动脉病变程度与相关危险因素之间存在密切联系，CAD患者合并MS可加重冠状动脉的病变程度，推测进行早期干预MS可能有助于减少心肌的损害程度，改善患者的预后。Objective To discuss the impairment of coronary artery and its correlated factors in coronary atherosclerotic heart disease （ CAD ） patients with metabolic syndrome （ MS ）, and to explore the relationship between body mass index （ BMI） and the degree of the impairment of coronary artery in CAD patients with MS. Methods 179 CAD patients diagnosed by coronary arteriography were divided into two groups ： MS group of 99 cases and non - MS group of 80 cases. Gensini scoring of coronary artery impairment, left ventricular ejection fraction （LVEF） measured by echocardiography, blood pressure, BMI, fasting blood glucose, two hours postprandial blood glucose, blood lipid, fibrinogen （ FIB） , B - type natriuretic peptide （BNP） and high - sensitive C - reactive protein （ hs - CRP） of the two groups were compared respectively. The 99 MS patients were divided into two groups according to the severity of MS： the severe group of 52 cases and the mild group of 47 cases. Gensini scoring of the impairment of coronary artery, LVEF, blood pressure, BMI, fasting blood glucose, two hours＇postprandial blood glucose, blood lipid, FIB, BNP and hs - CRP of the two groups were also compared. Results There was a significant difference between MS group and non - MS group in Gensini scoring of the impairment of coronary artery, LVEF, blood pressure, BMI, fasting blood glucose, two hours postprandial blood glucose, blood lipid, FIB, BNP and hs- CRP（ P 〈 0.05 or P 〈 0.01）. There was also a significant difference between the se- vere MS group and the mild MS group in Gensini scoring of the impairment of coronary artery, BMI, total cholesterol, triglyceride, HDL, FIB, BNP and hs - CRP （ P 〈 0.05 or P 〈 0.01）. The correlation between BMI and the degree of the impairment of coronary artery was positive in patients with severe MS. Conclusion There is significant relationship between the degree of impairment of coronary artery and its correlated factors in CAD patients with MS. The impairment of co

关 键 词：冠状动脉粥样硬化性心脏病 代谢综合征 冠状动脉造影 相关因素 

分 类 号：R541.4[医药卫生—心血管疾病]