青年冠心病患者临床特点及危险因素分析  

Clinical features and risk factors of coronary heart disease in young patients

作　　者：王越越[1] 汪琦瑛[2] 韩国鑫 申晓东[1] 夏蕾[3] 金琴花[4] 章明[4] 高磊[4] 黎檀实[1] 朱海燕[1] 

机构地区：[1]解放军总医院急诊科,北京100853 [2]解放军总医院医务部,北京100853 [3]解放军总医院保障部,北京100853 [4]解放军总医院心血管内科,北京100853

出　　处：《中华急诊医学杂志》2015年第4期386-390,共5页Chinese Journal of Emergency Medicine

摘　　要：目的 探讨青年冠心病患者的临床特点并分析其发病的危险因素.方法 对解放军总医院2014年1月至12月收治的220例年龄＜45岁因胸痛行选择性冠状动脉造影青年患者的一般资料和血生化指标水平进行回顾性分析,比较冠脉造影阳性组与阴性组之间的差异.所有统计分析采用Stata 7.0统计软件,计量资料以均数±标准差（（x）±s）表示,采用成组t检验或Wilcoxon秩和检验,计数资料以例数和百分比表示,采用x2检验,并进行Logistic回归分析,总结青年人冠心病发生的临床特点及危险因素,以P＜ 0.05为差异具有统计学意义.结果 冠脉造影阳性的青年患者男性（P=0.002 5）、吸烟史（P=0.0365）、高血压史（P=0.003 5）、肌钙蛋白T（cTnT）（P=0.000）、B型钠尿肽（BNP） （P =0.000）、总胆固醇（TC） （P=0.0232）、低密度脂蛋白胆固醇（LDL-C） （P =0.040 9）、血糖（P =0.000）、纤维蛋白原（Fib） （P =0.035）水平均明显高于阴性组,差异具有统计学意义（P＜0.05）.总胆红素（TBIL） （P =0.001）、直接胆红素（DBIL） （P =0.0048）水平均明显低于阴性组,差异具有统计学意义（P＜0.05）.冠脉造影阳性与否与青年患者性别（OR =3.4）、吸烟史（OR=2.4）、高血压病史（OR=1.98）、TC（OR=1.34）、LDL-C（OR =1.38）、Fib（OR=1.77）、TBIL （OR =0.91）和DBIL（OR=0.77）水平呈显著相关性.结论 男性、高血压病史、吸烟史、高总胆固醇、高低密度脂蛋白胆固醇、高纤维蛋白原、低胆红素是青年人群发生冠心病的危险因素,应对这部分人群进行早期预防与治疗.Objective To explore the clinical features and risk factors of young patients with coronary heart disease （CHD）.Methods A total of 220 young patients presenting angina pectoris under age 45 were admitted from January to December in 2014 in our hospital.During study,all patients were checked with selective coronary angiography.The patients were divided into positive group （n =156） and negative group （n =64） as per coronary angiography results.And the demographics of patients and levels of blood biochemical markers were comparatively analyzed between two groups.Stata 7.0 software was used to perform all statistical evaluations.Quantitative variables were presented as means ± standard deviations and compared using t-test or Wilcoxon-rank sun test,categorical data were presented as absolute values and percentages and compared using Chi-square test,and Logistic regression analysis were used to analyze the clinical characteristics and the risk factors.P 〈 0.05 was considered statistically significant.Results The male young patients were very vulnerable to CHD confirmed by positive angiographic findings （141/156,90.4%,P =0.002 5）,and they had higher rates of smoking history （P =0.036 5） and hypertension history （P =0.0035）,higher levels of cardiac troponin T （cTnT） （P =0.000）,brain natriuretic peptide （BNP） （P =0.000）,total cholesterol （TC） （P =0.023 2）,low-density lipoprotein cholesterol （LDL-C）（P =0.0409）,glucose （P =0.000）,fibrinogen （Fib） （P =0.035）,lower total bilirubin （TBIL） （P =0.001） and direct bilirubin （DBIL） （P =0.004 8） compared with the male patients in negative group （47/64,73.4%,P 〈0.05）.The results of coronary angiography were significantly associated with gender （OR=3.4）,smoking history （OR =2.4）,hypertension history （OR =1.98）,levels of TC （OR =1.34）,LDL-C （OR =1.38）,Fib （OR =1.77）,TBIL （OR =0.91） and DBIL （OR =0.77）.Conclusions Male gender,hypertension history,smoking history,h

关 键 词：青年 冠心病 危险因素 性别 高血压 吸烟 总胆固醇 低密度脂蛋白胆固醇 纤维蛋白原 胆红素 

分 类 号：R541.4[医药卫生—心血管疾病]