代谢综合征及其成分对冠状动脉病变进展的作用  

Effect of metabolic syndrome and its components on the progression of coronary artery lesion

作　　者：汤磊乐 黄卓山 董睿敏[1] 温哲琦 陈璘[1] 

机构地区：[1]中山大学附属第三医院心血管内科,广州510630 [2]中山大学附属第一医院心血管内科,广州510700

出　　处：《新医学》2017年第5期332-337,共6页Journal of New Medicine

基　　金：广东省科技厅面上计划项目(2009B030801146)

摘　　要：目的分析代谢综合征(MS)及其成分对冠状动脉粥样硬化性病变进展的作用。方法行冠状动脉造影或冠状动脉CT血管造影检查,并在间隔≥6个月后复查冠状动脉情况的患者245例,根据是否为MS、冠状动脉病变进展、冠状动脉病变明显进展进行分组。比较组间临床资料及生化水平差异。并通过回归分析,分析MS及其成分对冠状动脉病变进展的作用。结果 MS组与非MS组对比,MS组Gensini进展率[2.8(0.0,11.9)vs.0(0.0,4.4),P=0.007],复查Gensini评分[9.8(5.0,23.8)vs.5.0(1.0,15.0),P=0.008],冠状动脉病变明显进展发生率(59.1%vs.45.2%,P=0.037)比非MS组的高。通过单因素回归分析,MS发病率与冠状动脉病变明显进展正相关(OR=1.75,95%CI:1.03~2.97,P=0.038)。通过多因素回归分析,是否有高血压病与冠状动脉病变进展(OR=2.60,95%CI:1.44~4.70,P=0.002)、明显进展相关(OR=3.36,95%CI:1.82~6.22,P<0.001)。结论 MS组的冠状动脉病变进展速度更快。MS成分中,高血压病可能是导致冠状动脉病变进展的主要危险因素。Objective To evaluate the effect of metabolic syndrome （ MS） and MS components on the progression of coronary artery lesions. Methods In total, 245 patients who underwent coronary angiogra-phy or coronary 320-slice CTA and received reexamination after a minimum interval of 6 months were recruited and divided into non-MS group and MS group, non-progress group and progression group, non-obvious progress group and obvious progress group respectively. Clinical data and biochemical parameters were statistically com-pared among different groups. The relationship between MS, MS components and coronary artery lesions was analyzed by logistic regression analysis. Results Compared with the non-MS group, the progression rate of Gensini score [2.8 （0.0,11.9） vs. 0.0（0.0,4.4） , P=0.007] , Gensini score during follow-up [9. 8（5.0 ,23.8）vs. 5.0（1.0,15.0） , P=0.008] and the incidence of significant progression of coronary artery lesions （59. 1% vs. 45. 2% , P = 0.037 ） were significantly higher in the MS group. Univariate regression analysis demonstrated that the incidence of MS was positively correlated with significant progression of coronary artery lesions（OR=1.75 , 95% CI：1.03-2.97 , P=0.038 ） . According to multivariate regression analysis, hyper-tension was positively correlated with the progression （OR= 2.60 , 95% CI： 1.44-4.70 ,P =0.002 ） and sig-nificant progression of coronary artery lesions （OR= 3.36,95% CI： 1.82-6.22 , P〈0.001） . Conclusions The progression of coronary artery lesion in the MS group is faster than that in the non-MS group. Among MS components, hypertension is probably the major risk factor for the progression of coronary artery lesions.

关 键 词：代谢综合征 代谢综合征组成成分 冠状动脉病变进展 高血压病 

分 类 号：R541.4[医药卫生—心血管疾病]