不同年龄冠状动脉旁路移植术患者的代谢性危险因素特征分析  

Metabolic risk factors between elderly and non-elderly patients with coronary heart disease

作　　者：包柄楠[1,2] 孙秀芹[1,2] 赵怡[1,2] 陶红[1,2] 周迎生[1,2] 

机构地区：[1]首都医科大学附属北京安贞医院 [2]北京市心肺血管疾病研究所内分泌科,100029

出　　处：《中国心血管杂志》2013年第1期1-5,共5页Chinese Journal of Cardiovascular Medicine

摘　　要：目的探讨不同年龄行冠状动脉旁路移植术(CABG)的冠心病患者代谢性危险因素特征。方法回顾性分析199例行CABG的冠心病患者的临床资料,根据年龄分为中青年组(年龄34～65岁,124例)和老年组(年龄≥65岁,75例),又根据冠状动脉病变程度分为多支病变亚组(病变支数≥3支)和非多支病变亚组(病变支数<3支),比较两组及亚组的代谢性危险因素特征。结果(1)中青年组高密度脂蛋白胆固醇(HDL-C)水平低于老年组,体质指数(BMI)、舒张压(DBP)高于老年组(均为P<0.05);老年组血肌酐(Cr)水平、高血压患病比例高于中青年组(均为P<0.05)。(2)中青年多支病变亚组空腹血糖(FPG)(7.21±3.44)mmol/L、DBP(79±10)mm Hg高于老年多支病变亚组(6.26±1.41)mmol/L、(75±11)mm Hg(P=0.034、0.03);HDL-C(1.07±0.26)mmol/L低于老年多支病变亚组(1.19±0.26)mmol/L(P=0.011)。(3)中青年非多支病变亚组的BMI、DBP高于老年组(均为P<0.05)。结论与老年组相比,低HDL-C、高BMI、高DBP是中青年冠心病CABG患者的代谢特征;高FPG是中青年冠心病多支病变CABG患者的代谢特征。Objective To analyze the metabolic risk factors between elderly and non-elderly patients with coronary heart disease underwent coronary artery bypass grafting. Methods Clinical data of 199 hospitalized patients with CAD （mean age, 60. 7 ±9. 8 years old; male, 71.9% ） were analyzed. The patients were classified into two groups as non-elderly patients （ 34 - 65 years old, n = 124 ） and elderly patients （≥65 years old, n = 75 ） for analysing the metabolic risk factors between them ; according to the numbers of obstructive vessels, two subgroups were respectively divided as multiple vessel lesions （ ≥ 3 vessels） and the control （ 〈 3 vessels） for analysing the metabolic risk factors between them. Results （ 1 ） The high-density lipoprotein cholesterol （HDL-C） in the non-elderly patients were lower than that in the elderly patients, but the body mass index （BMI） and diastolic blood pressure （DBP） in the non-elderly patients were higher than those in the elderly patients （P 〈 0. 05 ） ; the serum creatinine （Cr） level and rate of hypertension in the elderly patients were higher than those in the non-elderly patients （ P 〈 0. 05 ）. （ 2 ） The fasting plasma glucose （FPG） （7.21 ± 3.44） mmol/L and DBP（ 79 ±10 ） mm Hg in the multiple vessel lesions subgroup within the non-elderly patients were significantly higher than those in the elderly multiple vessel lesions subgroup （6. 26 ± 1.41 ） mmol/L, （75± 11 ） mm Hg. （ P = 0. 034,0. 03 ） ; The HDL-C （ 1.07 ± 0. 26） mmol/L was lower than that in the elderly multiple vessel lesions subgroup （ 1.19 ± 0. 26）mmol/L （P = 0. 011 ）. （3） The BMI and DBP in the non-elderly control subgroup were significantly higher thanthose in the elderly control subgroup （ all P 〈 0. 05 ）. Conclusions Low level of HDL-C and high levels of BMI and DBP are the metabolic characteristics of the non-elderly patients with coronary heart disease underwent CABG. High level of FPG is the metabolic cha

关 键 词：年龄 冠状动脉疾病 冠状动脉旁路移植术 危险因素 

分 类 号：R654.2[医药卫生—外科学]