冠状动脉病变程度的影响因素分析  

Analysis of the influencing factor on the severity of coronary artery disease

作　　者：高娟[1] 车海蓝 韩江红[1] 尹宏磊[2] 户富栋[2] 

机构地区：[1]新乡医学院三全学院护理学院,河南新乡453000 [2]新乡医学院第一附属医院心内科,河南新乡453100

出　　处：《蚌埠医学院学报》2016年第3期333-336,共4页Journal of Bengbu Medical College

摘　　要：目的：探讨冠状动脉（冠脉）病变程度的主要影响因素。方法：选择行冠脉造影并诊断为冠心病的患者265例,另选经冠脉造影证实冠脉正常者64名作为对照。记录冠心病危险因素,包括性别、年龄、高血压、糖尿病、高脂血症、低高密度脂蛋白胆固醇（HDL-C）、高尿酸血症、早发心血管病家族史、吸烟情况。采用冠脉造影后是否诊断冠心病、病变支数及Gensini积分评估冠脉病变程度。应用单因素及多因素回归分析评估危险因素与病变程度的关系。结果：年龄、男性、高血压、糖尿病、吸烟及低HDL-C均与冠脉病变程度有关（P〈0.01）;年龄、空腹血糖、血尿酸、低密度脂蛋白胆固醇与Gensini积分均呈正相关关系（P〈0.05～P〈0.01）,HDL-C与Gensini积分呈负相关关系（P〈0.05）;年龄、收缩压、血尿酸与冠脉病变支数均呈正相关关系（P〈0.05～P〈0.01）。多元线性回归分析显示,对冠脉病变程度影响较大的危险因素依次为男性、年龄、高血压和糖尿病（标准回归系数B分别为0.279、0.189、0.164、0.116）;logistic回归分析显示,年龄、男性、高血压、糖尿病为冠心病的主要独立危险因素,其中OR值较高者为糖尿病（OR=5.789）和男性（OR=5.516）,其次为高血压（OR=2.407）和年龄（OR=2.093）（P〈0.05～P〈0.01）。结论：年龄、男性、高血压和糖尿病为冠脉病变程度的主要独立影响因素,应重视高血压和糖尿病的预防和控制。Objective： To investigate the influencing factors of the severity of coronary artery disease（ CAD）. Methods： Two hundred and sixty-five CAD patients and 64 normal people diagnosed by coronary angiography were invetigated. The risk factors of coronary disease,included male,age,hypertension,diabetes mellitus,hyperlipemia,lower serum high density lipoprotein cholesterol（ HDL-C）,hyperuricemia,family history and smoking,were recorded. The severity of CAD,number of disease vessels and scores of Gensini were determined by coronary angiography. The relationship between risk factor and severity of CAD was analyzed using the univariate analysis and multivariate logistic regression. Results： The univariate analysis showed that the age,male,hypertension,diabetes mellitus,smoking and lower HDL-C were associated with the severity of CAD,the age,fasting blood glucose,serum uric acid,LDL-C were postive correlation with Gensini scores（ P〈0. 05 to P〈0. 01）,the HDL-C was negatively correlated to Gensini scores（ P〈0. 05）,and the age,systolic pressure and serum uric acid were postively correlated to the number of diseased vessels（ P〈0. 05 to P〈0. 01）.Multivariate linear regression analysis showed that male was the most risk factor in severity of CAD,and followed by age,hypertension and diabetes mellitus（ standandized coefficients B for 0. 279,0. 189,0. 164 and 0. 116,respectively）. Logistic regression analysis showed that the age,male,hypertension and diabetes mellitus were the independent risk factors for CAD,and the Odds Ratio（ OR）value of diabetes mellitus and male were higher（ OR = 5. 789 and OR = 5. 516）,followed by hypertension（ OR = 2. 407） and age（ OR =2. 093）（ P〈0. 05 to P〈0. 01）. Conclusions： The age,male,hypertension,diabetes mellitus are the main influencing factors on CAD,and the hypertension and diabetes mellitus should be prevented and controled.

关 键 词：冠心病 危险因素 冠状动脉造影 GENSINI积分 

分 类 号：R541.4[医药卫生—心血管疾病]