影响冠状动脉粥样硬化的程度及病变支数的常见危险因素  

Common risk factors for number of stenotic branches and degree of coronary atherosclerosis

作　　者：田作军[1] 邓宇[2] 杨碧萍[1] 曾昭华[3] 由天辉[4] 陆亚琴[5] 

机构地区：[1]广州医学院第一附属医院神经内科,广州510120 [2]广州医学院第一附属医院放射科,广州510120 [3]广州医学院第一附属医院心内科,广州510120 [4]广东药学院护理学院,广州510310 [5]广州医学院护理学院,广州510182

出　　处：《广东医学》2010年第22期2903-2906,共4页Guangdong Medical Journal

基　　金：广东省科技计划项目(编号:2009B030801341);广东省医学科研基金立项项目(编号:A2010224);广州市属高校科技计划项目(编号:08A094)

摘　　要：目的探讨临床常见危险因素对冠状动脉粥样硬化的程度及病变支数的影响。方法对276例疑诊冠心病患者进行冠脉CTA检查,根据冠状动脉(冠脉)CTA结果,将冠脉粥样硬化程度及病变支数分别分为无狭窄、轻度狭窄(直径>50%)及重度狭窄(直径≤50%)3组以及无病变、单支及多支(≥2支)病变3组,分别以2检验及有序分类logistic回归分析临床常见危险因素对冠脉狭窄程度及病变支数的不同影响。结果对冠脉的狭窄程度和病变支数的单因素分析分别发现:年龄(2=14.394,P=0.006)、高血压(2=6.445,P=0.040)、总胆固醇(TC)(2=10.344,P=0.006)、三酰甘油(TG)(2=7.084,P=0.029)及低密度脂蛋白(LDL)(2=8.162,P=0.017)对冠状动脉粥样硬化的程度均有影响,而冠脉的病变支数主要受吸烟影响(2=15.842,P=0.000)。多因素分析发现:冠脉的狭窄程度及病变支数均以年龄(均P<0.01)、吸烟(均P<0.01)及TC(均P<0.05)作为主要危险因素。结论年龄、吸烟及TC对冠状动脉粥样硬化的程度及病变支数均有重要影响;高血压、TG、LDL容易影响冠脉的狭窄程度,吸烟容易导致冠脉的多支弥漫性病变。Objective To explore the impact of common risk factors on the number of stenotic branches and degree of coronary atherosclerosis （CA）. Methods Two hundred and seventy-six inpatients with doubtful coronary heart disease were enrolled and cardiac CTA was carried out on each subjects. Subjects were classified into coronary atherosclerosis-free group,mild atherosclerosis group （dia.〉50%） and severe atherosclerosis group （dia.≤50%） according to the atherosclerosis degree in CTA,meanwhile,into coronary atherosclerosis-free group,uni-branch group and multi-branches group according to the atherosclerosis branches number. χ^2 test and ordinal logistic regression analysis were used to identify the impact of the common risk factors on the degree and stenotic branches numbers of CA. Results CA degree was significantly correlated with age （ χ^2=14.394,P=0.006）,hypertension （ χ^2=6.445,P=0.040）,total cholesterol （TC） （ χ^2=10.344,P=0.006）,triglyceride （TG） （ χ^2=7.084,P=0.029） and low density lipoprotein （LDL） （ χ^2=8.162,P=0.017）,while,the CA branches number was correlated with smoking according to univariate analysis. Meanwhile,age （P0.01）,smoking （P0.01） and TC （P0.05） were the main risk factors for the degree and the number of stenotic branches of CA. Conclusion Age,smoking and TC have impact on both the degree and the number of stenotic branches of CA,meanwhile,hypertension,TG and LDL are the risk factors for degree of CA and smoking is risk factor for the numbers of CA branches.

关 键 词：冠状动脉 粥样硬化 危险因素 统计 

分 类 号：R541.4[医药卫生—心血管疾病]