天津地区冠状动脉病变程度与冠心病患者心血管疾病的多因素分析  

An analysis of relationship between the severity of coronary artery lesion and risk factors of cardiovascular events in Tianjin

作　　者：肖健勇[1] 张赫男[1] 曹路[1] 丛洪良[1] 

机构地区：[1]天津市胸科医院心内科,300051

出　　处：《中华危重病急救医学》2013年第11期650-654,共5页Chinese Critical Care Medicine

基　　金：天津市科技计划支撑项目（12ZCZDSY03200）

摘　　要：目的 探讨天津地区冠状动脉（冠脉）病变程度与冠心病患者心血管疾病危险因素的关系.方法 采用回顾性研究方法,选取在天津市胸科医院行冠脉造影术（CAG）确诊为冠心病的1 629例患者,依据CAG结果的SYNTAX评分将患者分为低分（0～22分,962例）、中分（23～32分,446例）及高分（≥33分,221例）3组.对冠脉病变程度与冠心病危险因素进行单因素和多因素logistic回归分析.结果 单因素分析结果显示,冠脉病变程度越重,SYNTAX评分越高,存在单个危险因素如高龄、男性、吸烟史、高血压史、2型糖尿病史、血脂异常的患者比例越高,高密度脂蛋白胆固醇（HDL-C）越低,低密度脂蛋白胆固醇（LDL-C）、总胆固醇（TC）、纤维蛋白原（FIB）、体质量指数（BMI）越高（均P＜0.01）.多因素logistic回归分析结果显示,男性、高龄、高血压史、2型糖尿病史、TC为冠脉病变程度加重的独立危险因素,其中高血压史[优势比（OR）=3.947,95％可信区间（95％CI）为1.455～ 10.704,P＜0.001]和2型糖尿病史（OR=5.760,95％CI为2.549～13.018,P＜0.001）为最显著的独立危险因素；HDL-C则为冠脉病变的保护因素（OR=0.541,95％CI为0.295～ 0.992,P=0.004）.结论 冠心病患者冠脉病变程度与多种危险因素有关,其中2型糖尿病和高血压是最显著的独立危险因素.在冠心病患者的二级预防中应加强对其血压、血糖、血脂的综合控制.Objective To evaluate the correlation between the severity of coronary artery lesion and multiple risk factors of events of coronary heart disease （CHD） in patients with coronary arteriography （CAG） in Tianjin.Methods A retrospective study was conducted.One thousand six hundred and twenty-nine patients with CHD as diagnosed with CAG in Tianjin Chest Hospital were enrolled in the study.Using the SYNTAX score to evaluate the outcomes of CAG,the patients were divided into three groups,i.e.low （0-22,n=962）,medium （23-32,n=446）and high （≥33,n=221） score groups.The relationship between the severity of CHD patients and the risk factors was analyzed by both single factor analysis and multivariate binary logistic regression analysis.Results The single factor analysis results showed that the severer the coronary artery lesion,the higher the SYNTAX score,the higher the proportion of patients having one of single risk factors （old,male,smoking,hypertension,type 2 diabetes mellitus,blood lipid abnormality）,the lower the high density lipoprotein cholesterol （HDL-C）,and the higher the low density lipoprotein cholesterol （LDL-C）,total cholesterol （TC） level,fibrinogen （FIB） content,and body mass index （BMI,all P＜0.01）.The logistic regression analysis showed that male,old age,hypertension,type 2 diabetes mellitus,TC were the independent risk factors in aggravating the severity of CHD.Hypertension [odds ratio （OR）=3.947,95％ confidence interval （95％ CI） 1.455-10.704,P＜0.001] and type 2 diabetes mellitus （OR =5.760,95％ CI 2.549-13.018,P＜0.001） were the two most prominent predictors for CHD,while HDL-C was the protective factor for CHD （OR =0.541,95％ CI 0.295-0.992,P=0.004）.Conclusions The severity of CHD was closely related to various risk factors,among them hypertension and type 2 diabetes mellitus were the most predominant risk factors of CHD.Therefore it should be emphasized that clinicians should control blood pressure,blood glucose,and also blood lipid

关 键 词：冠心病 冠状动脉造影术 危险因素 SYNTAX评分 

分 类 号：R541.4[医药卫生—心血管疾病]