188例早发冠心病患者危险因素及冠脉病变特点临床分析  

Clinical Study on the Risk Factors and Coronary Features of Patients with Premature Coronary heart Disease

作　　者：詹美恩 陈开[1] 汤文信 刘增荣[1] 叶承刚[1] 朱铁宾[2] 

机构地区：[1]安徽省天长市人民医院心内科,安徽天长239300 [2]江苏省人民医院心内科,江苏南京210029

出　　处：《现代生物医学进展》2013年第6期1137-1141,共5页Progress in Modern Biomedicine

基　　金：江苏省高校自然科学基金项目(06 kjb 320006)

摘　　要：目的:分析早发冠心病患者临床危险因素及冠脉病变的特点,以便对其早期干预及优化治疗。方法:回顾性分析373例在我院行冠脉造影术确诊为冠心病的患者,按年龄分为早发冠心病组188例(男≤55岁,女≤65岁)和晚发冠心病组185例,对两组患者的体重指数(BMI)、高血压病史、糖尿病史、高血脂病史、吸烟史、饮酒史、早发心血管病家族史,血脂、血糖、尿酸、胆红素水平及冠脉病变情况进行统计学分析。结果:早发冠心病组肥胖、吸烟史、饮酒史、高血脂史、早发冠心病家族史及甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白(LDL-C)、脂蛋白a(LPa)水平明显高于晚发冠心病组,差异有统计学意义(P<0.05);糖尿病发病率低于晚发冠心病组,差异有统计学意义(P<0.05);高血压发病率低于晚发冠心病组,但差异无统计学意义(P>0.05);冠脉病变主要是单支病变多见,与晚发冠心病组相比,差异有统计学意义(P<0.05)。结论:肥胖、吸烟、饮酒、早发心血管病家族史、高脂血症是早发冠心病的主要危险因素,故早期干预有助于降低早发冠心病发病率。早发冠心病患者以单支病变多见,故给予合理支架植入及必要的药物优化治疗,可明显的改善其预后。Objective： To explore the risk factors and clinical manifestation of coronary lesions in patients with premature coro-nary heart disease （PCHD）, and to prior intervention and optimize therapeutic, Methods： A retrospective analysis of 373 cases of coronary artery disease patients underwent coronary angiography confirmed, 188 patients with PCAD and 185 patients with late CHD （LCHD） were divided by age. The relationship among the risk factors including body mass index （BMI）, history of hypertension, diabetes, hyper- lipemia, smoking, alcohol consumption, premature family history of cardiovascular disease, and level of lipidemia, glucose, uricemia, bilirubin and clinical features of coronary lesions in coronary features were analyzed. Results： Patients with PCHD had higher levels of BMI, triglyceride （TG）, total cholesterol （TC）, low-density lipoprotein cholesterol （LDL-c） and LP（a） compared with the LCAD group （P〈0.05）. The PCAD group had lower rate of diabetes （P〈0.05）, and hypertension （P 〉 0.05）. The patients with PCHD had lesions in single coronary artery （P〈0.05）. Conclusion： Patients with PCHD had many clinical cardiovascular risk Factors, including obesity, smoking, alco-hol consumption, premature family history of cardiovascular disease, hyperlipemia is a major risk factor for PCHD, so early preventing can help reduce the incidence of PCHD. The patients with PCHD had more single vessel disease. These patients were given a reason-able stent and the optimized drugs, which can significantly improve the prognosis.

关 键 词：早发冠心病 危险因素 冠脉病变 

分 类 号：R541.4[医药卫生—心血管疾病]