冠状动脉多支血管病变合并左心室功能障碍患者临床特征及危险因素研究  

Clinical Characteristics of Multivessel CAD Combined with LVD and Its Risk Factors

作　　者：刘紫东[1] 张志[1] 付伟[1] 

机构地区：[1]辽宁医学院附属第三医院心内科,辽宁省锦州市121001

出　　处：《中国全科医学》2013年第23期2688-2690,共3页Chinese General Practice

摘　　要：目的探讨冠状动脉多支血管病变合并左心室功能障碍患者的临床特征及危险因素。方法选择2009年6月—2012年9月384例在我院行冠状动脉造影检查提示存在多支血管病变的患者为研究对象,依据心脏超声结果分为两组:左室射血分数(LVEF)≥50%组(n=266)和LVEF<50%组(n=118),记录两组患者住院期间的临床资料,对相关因素进行单因素和多因素Logistic回归分析。结果与LVEF≥50%组比较,LVEF<50%组男性比例及心肌梗死病史、糖尿病病史、不稳定性心绞痛的发生率高,高血压和血脂异常发生率低,差异均有统计学意义(P<0.05)。单因素Logistic回归分析显示:男性、心肌梗死病史、糖尿病病史、高血压、血脂异常及不稳定性心绞痛进入回归方程〔比值比(OR)及95%可信区间(CI)分别为:1.808(1.070,3.057),3.289(2.094,5.165),1.641(1.028,2.620),0.556(0.359,0.861),0.497(0.292,0.844),1.579(1.005,2.479)〕。多因素Logistic回归分析显示:心肌梗死病史、糖尿病病史、高血压及血脂异常进入回归方程〔OR(95%CI)分别为:3.314(2.048,5.363),2.415(1.346,4.332),0.597(0.366,0.973),0.364(0.197,0.675)〕。结论心肌梗死病史、糖尿病是多支血管病变(严重冠心病)患者合并左心室功能障碍的危险因素;高血压,血脂异常则为保护因素。Objective To discuss the clinical characteristics of multivessel coronary artery disease （CAD） combined with left ventricular dysfunction （LVD） and its risk factors. Methods A total of 384 multivessel CAD patients diagnosed by coronary angiography from June 2009 to September 2012 were divided, according to echocardiography results, into groups A [ left ventricular ejection fraction （LVEF） ≥50%, n =2661, B （LVEF 〈50%, n = 118）. The clinical data were recorded and univariate and multivariate Logistic regression analysis performed. Results The proportion of male, history of myocardial infarc- tion （ MI）, incidence of diabetes and unstable angina （USA） were higher in group B them in group A, and incidence of hyper- tension and dyslipidemia lower, the difference was significant （P 〈 0. 05）. By univariate Logistic regression analysis, male, MI history, diabetic history, hypertension, dyslipidemia and USA were taken into regression equation, odds ratio （OR） and 95% confidence interval （95% CI） were 1.808 （1.070, 3.057）, 3.289 （2.094, 5.165）, 1.641 （1.028, 2.620）, 0. 556 （0. 359, 0. 861 ）, 0. 497 （0. 292, 0. 844）, 1. 579 （ 1. 005, 2. 479）, respectively. By multivariate Logistic regres- sion analysis, OR （95% CI） of MI history, diabetic history, hypertension, dyslipidemia were 3. 314 （ 2. 048, 5. 363 ）, 2.415 （1.346, 4.332）, 0.597 （0.366, 0.973）, 0.364 （0.197, 0.675）, respectively. Conclusion Histories of MI and diabetes are risk factors of muhivessel CAD combined with LVD, and hypertension, dyslipidemia are protective factors.

关 键 词：冠心病 血管 左室射血分数 心肌梗死 糖尿病 危险因素 

分 类 号：R541.4[医药卫生—心血管疾病]