老年人增龄、性别差异与冠心病的相关性研究  

Relationship between aging,gender and coronary heart disease(CHD) in the elderly

作　　者：刘莹[1] 陈庆伟[1] 吴庆[1] 柯大智[1] 邓玮[1] 姚武位[1] 李桂琼[1] 

机构地区：[1]重庆医科大学附属第二医院老年心血管科,重庆400010

出　　处：《重庆医科大学学报》2010年第3期403-407,共5页Journal of Chongqing Medical University

摘　　要：目的:探讨老年及高龄老年冠心病(Coronary heart disease,CHD)的危险因素及流行病学特征,评价老年人增龄、性别差异与CHD的相关性。方法:入选2002年4月～2007年12月行Judkins法冠状动脉造影的连续733例患者,比较非冠心病组(306例)、单支病变组(211例)、双支(126例)和多支病变组(90例)的年龄和基础临床指标,采用四分位法对Gensini积分进行分级,对不同Gensini积分水平患者的年龄、危险因素进行定量比较,所有对象分为4个年龄组:<60岁组(116例)、60～69岁组(200例)、70～79岁组(315例)、80岁～89岁组(102例),分析年龄、性别构成比对冠心病发病风险、病变范围和程度的影响,最后通过多元回归方法分析Gensini积分与年龄及危险因素的相关关系。结果:4个年龄组(<60岁组、60～69岁组、70～79岁组、80岁～89岁组)CHD的发病率分别为47.41%、50.50%、64.40%、68.30%,与60岁以下的人群相比,老年人年龄每增加10岁,CHD的发病危险分别增加12.70%、24.20%、31.70%。各年龄组男性CHD发病率均高于女性,男性CHD发病风险为女性的1.39倍(P<0.01)。年龄(P<0.01,P<0.01)、纤维蛋白原(FIB,P<0.05,P<0.01)、尿素氮(Bun,P<0.05,P<0.05,P<0.05)、肌酐(Cr,P<0.01,P<0.01,P<0.01)伴随冠脉病变的支数及Gensini积分的增加而上升,且多元回归分析显示,年龄、Bun、Cr和FIB都是Gensini积分的独立危险因素。结论:伴随增龄,CHD的发病风险逐渐上升,病变范围和程度也逐渐增加;男性为CHD的易患因素,与女性相比,男性CHD患者病变程度更重。Objective：To investigate the relationship between aging,gender and coronary heart disease（CHD） in the elderly and very elderly.Methods：A total of 733 consecutive patients underwent Judkins of coronary angiography for enrolled in this study from April 2002 to Dec.2007.Age and clinical characteristics of non-coronary heart disease group（n=306）,single-vessel group（n=211）,double-（n=126） and multi-Vessel group（n=90） were compared referred for angiography.Quantitative comparison of age and risk factors were made among patients with 4 ranges of Gensini＇s score corresponding to quartile cut points.The impact of age,gender on CHD was analyzed in four age groups：60-year-old group（n=116）,60 to 69-year-old group（n=200）,70 to 79-year-old group（n=315）,80-year-old to 89-year-old group（n=102）,multiple regression analysis was performed to identify the association between Gensini＇s score and age and risk factors.Results：The CHD incidence of 60-year-old group,60 to 69-year-old group,70 to 79-year-old group and 80-year-old to 89-year-old group was 47.41%,50.50%,64.40% and 68.30% respectively,and for each 10-year-old increase in the elderly ≥60 years old,the risk of having CHD increase by 12.70%,24.20% and 31.70%.Throughout all age groups in this study,men have a higher incidence than female,the male to female risk ratio of CHD was 1.39（P 0.01）.Age（P 0.01,P 0.01）,fibrinogen（FIB,P 0.05,P 0.01）,urea nitrogen（Bun,P0.05,P 0.05,P 0.05）,creatinine（Cr,P 0.01,P 0.01,P 0.01） increased significantly accompanied by the progression of coronary atherosclerosis and Gensini Score.Multiple regression analysis showed that,Bun,Cr and FIB are independent risk factors of Gensini Score.Conclusions：Aging and male was important risk factors of progression of coronary atherosclerosis.

关 键 词：冠心病 老年人 增龄 性别 危险因素 

分 类 号：R541.4[医药卫生—心血管疾病]