青年冠心病患者的临床特征与青年人冠心病发病相关因素  

Clinical Features of Young Patients with Coronary Heart Disease and Coronary Heart Disease-related Factors in Young People

作　　者：刘金涛[1] 王梅[2] 周芸[2] 严研[2] LIU Jintao WANG Mei ZHOU Yun YAN Yan(Department of Emergency, Changping Hospital of Integrated Chinese and Western Medicine,Beifing 102208, China Department of Emergency,Beifing Anzhen Hospital, Capital Medical University,Beijing 100029, China)

机构地区：[1]北京市昌平区中西医结合医院急诊科,北京102208 [2]首都医科大学附属北京安贞医院急诊科,北京100029

出　　处：《医学综述》2017年第1期134-137,共4页Medical Recapitulate

基　　金：首都医科大学附属北京安贞医院院长科技发展基金(2015P02)

摘　　要：目的分析青年冠状动脉粥样硬化性心脏病(冠心病)患者的临床特征与青年人冠心病发病相关因素。方法选择2013年5月至2014年12月于北京市昌平区中西医结合医院住院治疗的183例冠心病患者及同期进行健康检查的60例青年志愿者(<45岁)为研究对象。根据冠心病患者的年龄将冠心病患者分为青年组(<45岁)和中老年组(≥45岁)。回顾性分析患者的青年冠心病患者的临床特征,采用Logistic多因素回归分析青年人冠心病发病相关因素。结果青年冠心病患者男性、吸烟史、饮酒史、早发冠心病家族史比例高于中老年患者(P<0.05),Gensini评分、高血压及糖尿病比例显著低于中老年患者(P<0.05);青年冠心病患者主要以单支、局限性血管病变为主,心律失常及心力衰竭的发生率低。青年冠心病组男性、早发冠心病家族史、存在吸烟史比例多于对照组,总胆固醇、低密度脂蛋白胆固醇(LDL-C)、纤维蛋白原水平高于对照组,血清尿酸水平低于对照组(P<0.05),两组三酰甘油、高密度脂蛋白胆固醇水平差异无统计学意义(P>0.05)。Logistic多因素回归分析结果显示,男性(OR=3.018,95%CI 1.713~5.317)、存在吸烟史(OR=2.035,95%CI 1.191~3.477)、高总胆固醇(OR=1.262,95%CI 1.063~1.498)、存在早发冠心病家族史(OR=1.043,95%CI 0.704~1.545)、高LDL-C(OR=1.247,95%CI 1.005~1.547)、高纤维蛋白原(OR=1.782,95%CI 1.194~2.660)、低血清尿酸(OR=1.183,95%CI1.043~1.342)是影响青年冠心病发病的主要危险因素(P<0.05)。结论青年冠心病主要为单支、局限性血管病变,男性、存在早发冠心病家族史、吸烟、高总胆固醇、高LDL-C、高纤维蛋白原及低血清尿酸是影响青年冠心病发病的主要危险因素。Objective To analyze the clinical features of young patients with coronary heart disease and the factors associated with coronary heart disease in young people. Methods A total of 183 coronary heart disease patients in Chang- ping Hospital of Integrated Chinese and Western Medicine from May 2013 to Dec. 2014, and 60 young volunteers （ 〈 45 years old） for health check during the same period were included in the study. According to the age, patients were divided into young group （ 〈45 years old） and older group（ I〉45 years old）. The clinical features of young patients with coronary heart disease were retrospectively analyzed. Logistic regression analysis was adopted to analyze the Coronary heart disease associated factors in young people. Results The male gender, smoking history, drinking history, family history of premature coronary heart disease in the young group were higher than those in the older group （ P 〈 0. 05 ）. Gensini score, rates of hypertension and diabetes in the young group were significantly lower than those in the older group （ P 〈 0. 05 ）. The single and limited coronary vascular disease were the main features and the incidence of arrhythmia and heart failure were lower in the young patients. Male, family premature coronary heart disease history, smoking history ratio in young coronary heart disease group were higher than those in control group;high total cholesterol,low density lipoprotein cholesterol （LDL-C）, high fibrinogen level in young coronary heart disease group were higher than those in control group ,low serum uric acid was lower than that in control group （P 〈 0.05 ）. triacylglycerol, high density lipoprotein cholesterol of the iwo group was no sta- tistically significant（P 〉 0.05 ）. Logistic multivariate regression analysis showed that the male（ OR = 3,018,95% CI 1. 713- 5. 317） ,smoking history （ OR = 2. 035,95% CI 1. 191-3. 477 ） and high total cholesterol （ OR = 1. 262,95% CI 1. 063- 1. 498 ） ,family history of prematore cor

关 键 词：冠心病 危险因素 青年 临床特征 

分 类 号：R541.4[医药卫生—心血管疾病]