冠状动脉造影检查疑似冠心病患者6040例合并传统心血管病危险因素的临床分析  

Real world analysis of traditional cardiovascular risk factors in 6040 patients with suspected coronary heart disease undergoing angiography

作　　者：江立生[1] 邵琴[1] 卜军[1] 何奔[1] 

机构地区：[1]上海交通大学医学院附属仁济医院心内科,上海200127

出　　处：《中国介入心脏病学杂志》2016年第9期497-501,共5页Chinese Journal of Interventional Cardiology

摘　　要：目的对临床上冠心病患者合并传统心血管病危险因素进行分析。方法纳入本中心2013年1月至2015年2月因冠心病或疑似冠心病行冠状动脉造影(CAG)检查的住院患者,将存在严重冠心病并接受经皮冠状动脉介入治疗(PCI)的患者归为PCI组(2808例),不存在严重冠心病且未行PCI/冠状动脉旁路移植术(CABG)的患者归为No-PCI/CABG组(3232例)。PCI组再分为急性ST段抬高心肌梗死(STEMI)组、非ST段抬高急性心肌梗死/不稳定型心绞痛(NSTEMI/UA)组和稳定型心绞痛(SA)组。对临床上合并的传统心血管病危险因素进行回顾性分析。结果 (1)PCI组患者男性比例(75.4%比53.1%,P<0.0001)、平均年龄[(64.83±0.20)岁比(63.39±0.18)岁,P<0.0001]、高血压病(66.7%比54.7%,P<0.0001)、糖尿病/糖耐量异常(37.0%比20.8%,P<0.0001)、卒中(7.0%比5.4%,P=0.0098)和慢性肾病(4.3%比2.8%,P=0.001)比例显著高于NoPCI/CABG组;而两组间高脂血症的比例,差异无统计学意义(P>0.05)。(2)PCI组中女性高血压病(74.1%比64.3%,P<0.0001)、糖尿病/糖耐量异常(42.5%比35.3%,P=0.0007)和卒中(9.4%比6.2%,P=0.0054)比例均显著高于男性,差异均有统计学意义;无论PCI组还是No-PCI/CABG组,女性高脂血症比例均显著高于男性。(3)对PCI组进行亚组分析发现,STEMI组男性比例显著高于NSTEMI/UA组和SA组(83.9%比72.9%比72.3%,P<0.0001),而发病年龄显著小于NSTEMI/UA组和SA组[(62.54±0.45)岁比(65.15±0.28)岁比(66.17±0.34)岁,P<0.0001]。SA组高血压病(71.9%比66.9%比60.0%,P<0.0001)和既往靶血管血运重建(PCI/CABG)(33.9%比18.7%比7.2%,P<0.0001)比例显著高于STEMI组和NSTEMI/UA组;NSTEMI/UA组糖尿病/糖耐量异常比例显著高于STEMI组和SA组(39.7%比35.1%比34.4%,P<0.0001),差异均有统计学意义;而高脂血症、慢性肾病和卒中的比例三亚组间差异无统计学意义(P>0.05)。结论高血压病和糖尿病是冠心病最重要的危险因素,既往靶血管血运重建是SA和NSTEMI/UA患者靶�Objective To analyze the real world status of traditional known cardiovascular risk factors in patients with coronary heart disease （ CHD ） .Methods 6040 in-hospital patients with CHD or suspected CHD undergoing angiography from 01/01/2013 to 02/28/2015 were retrospectively analyzed . According to angiography result , patients with severe coronary artery lesion and undergoing percutaneous coronary intervention （PCI） were enrolled in the PCI group （n=2808） and patients without severe coronary artery lesion and not undergoing PCI or CABG were enrolled in the No-PCI/CABG group （n=3232）.Patients in the PCI group were further divided into 3 subgroups which were STEMI group , NSTEMI/UA group and stable angina （SA） group.Results （1） Compared with the No-PCI/CABG group, patients in the PCI group have higher ratio of male patients （75.4% vs.53.1%, P〈0.0001）, older average age （64.83 ±0.20 vs. 63.39 ±0.18 years old , P 〈0.0001 ） , and higher existing rates of traditional risk factors including hypertension （66.7%vs.54.7%, P〈0.0001 ） , diabetes/impaired glucose tolerance （ IGT ） （ 37.0% vs.20.8%, P〈0.0001）, stroke（7.0%vs.5.4%,P=0.0098）and chronic kidney disease （CKD） （4.3%vs. 2.8%, P=0.001 ） , but there was no statistic difference in existing rates of dyslipidemia between the two groups.（2）In the PCI group,female patients had higher prevalence of hypertension （74.1%vs.64.3%, P〈0.001）, diabetes/IGT （42.5%vs.35.3%, P=0.0007） and stroke （9.4%vs.6.2%, P=0.0054） than the male patients.There were no significant sex difference in these comorbidities as above in No-PCI/CABG group.Female patients had higher prevalence of dyslipidemia than male patients in both PCI and No -PCI/CABG groups.（3） Among all the 3 PCI subgroups, STEMI patients presented with youngest average age （62.54 ±0.45 vs.65.15 ±0.28 vs.66.17 ±0.34 years old, P〈0.0001） and highest male patient ratio （83.9%vs.72.9% vs.72.3%, P〈0.0001）.Patients in the SA subgroup had

关 键 词：冠心病 介入治疗 危险因素 回顾性分析 

分 类 号：R541.4[医药卫生—心血管疾病]