冠心病危险因素与冠脉病变程度的相关分析  

Correlation between risk factors of coronary artery disease and severity of coronary artery disease

作　　者：冯高科[1] 汪小丁[1] 陈晶晶[1] 陈玺宇 蒋学俊[1] 

机构地区：[1]武汉大学人民医院心内科,武汉大学心血管病研究所,心血管病湖北省重点实验室,430060

出　　处：《中国医师杂志》2018年第1期72-75,共4页Journal of Chinese Physician

基　　金：武汉市青年科技晨光计划(2017050304010280);中央高校基本科研业务费专项资金项目(2042017kf0077)~~

摘　　要：目的分析冠心病危险因素的临床特点,探讨冠心病患者冠状动脉病变严重程度与冠心病危险因素的关系。方法将2013年4月至2014年8月本院进行冠心病230例患者分为两组,观察组为经过冠脉造影确诊为冠心病的患者170例(血管狭窄程度≥50%),对照组为冠状动脉粥样硬化患者60例(血管狭窄程度<50%),根据两组患者的临床资料,对冠心病危险因素进行研究,并探讨冠状动脉病变严重程度与冠心病危险因素之间的相关性。结果 2型糖尿病、吸烟、男性与冠心病有关,OR(95%CI)分别为17.489(11.013～30.017)、48.632(20.379～117.178)、18.976(13.105～28.331)。以冠脉病变程度为因变量,年龄、体重指数、性别、糖尿病、高血压、血脂紊乱、吸烟为自变量,非条件Logistic回归分析显示:吸烟、2型糖尿病与冠脉病变程度相关(P=0.03),OR(95%CI)分别为10.15(2.012～2.584)、7.23(1.613～2.176)。冠心病及其冠脉病变程度与年龄、高血压、血脂紊乱、体重指数无关。观察组左心室射血功能、hs-CRP、Ccr与冠脉病变程度有关,观察组患者存在Ccr水平降低,左心室射血功能减弱,hs-CRP水平升高(P=0.02)等情况,且上述三种因素的OR(95%CI)分别为1.986(5.204～17.627)、1.103(1.012～1.027)、2.131(1.901～2.369)。结论 2型糖尿病、吸烟、男性是冠心病的危险因素,与冠心病具有密切的联系,冠状动脉病变程度与患者心肾功能降低、hs-CRP水平升高有关。Objective To investigate the clinical characteristics of coronary heart disease risk fac- tors, and explore the relationship of severity of coronary artery lesions in patients with coronary heart disease and coronary heart disease risk factors. Methods In our hospital for treatment of coronary artery disease patients during April 2013 to August 2014, 230 cases of hospitalized patients were divided into two groups after coronary angiography diagnosis, including 170 cases of patients with coronary heart disease as the ob- servation group, and 60 patients with coronary atherosclerosis as the control group with the degree of stenosis less than 50%. The clinical data of two groups were used to study the risk factors for coronary heart disease. The relationship was analyzed between severity of coronary artery pathological changes and coronary heart disease risk factors. Results For the observation group, type 2 diabetes, smoking, and men were associat- ed with coronary heart disease （CHD）, with the corresponding OR （95% CI） of 17.489 （11.013 - 30. O17 ）, 48. 632 （20. 379 - 117. 178）, and 18. 976 （ 13. 105 -28.331 ）, respectively. Smoking and type 2 diabetes were associated with coronary artery stenosis degree （P 〈0. 05）, with OR 95% （CI） of 10. 15 （2. 012 -2. 584） , and of 7.23 （1. 613 -2. 176）. The results found there was no relationship among hy- pertension, dyslipidemia, coronary heart disease （CHD） , and age. There was a link between the body mass index （BMI） and the severity of the disease. For observation group, left ventricular ejection function, high-sensitivity C-reactive protein （ hs-CRP）, and Ccr were related to the severity of coronary lesions, andthe patients existed lower Ccr, left ventricular ejection function abate, and increased hs-CRP levels in- crease, P 〈0. 05, and the OR （95% CI） were 1. 986 （5. 204 - 17. 627）, 1. 103 （ 1. 012 - 1. 027）, and 2. 131 （ 1. 901 -2. 369）. Conclusions Type 2 diabetes, smoking, male patients with coro

关 键 词：冠心病 危险因素 冠状动脉疾病 

分 类 号：R541.4[医药卫生—心血管疾病]