冠心病患者动脉粥样非钙化斑块的影响因素分析  

Influencing factors of atherosclerotic noncalcified plaques in patients with coronary heart disease

作　　者：刘雪辉[1] 吴丽美[1] 刘达彬 张雅娟 李志海[1] 许卓帆[3] 伍绍国[1] Liu Xuehui;Wu Limei;Liu Dabin;Zhang Yajuan;Li Zhihai;Xu Zhuofan;Wu Shaoguo(Department of Clinical Laboratory,Guangzhou Twelfth People's Hospital,Guangzhou 510620,China;Department of Radiology,Guangzhou Twelfth People's Hospital,Guangzhou 510620,China;Department of Medicine-Cardiovascular,Guangzhou Twelfth People's Hospital,Guangzhou 510620,China)

机构地区：[1]广州市第十二人民医院检验科,510620 [2]广州市第十二人民医院放射科,510620 [3]广州市第十二人民医院心血管内科,510620

出　　处：《国际医药卫生导报》2021年第14期2084-2088,共5页International Medicine and Health Guidance News

基　　金：广东省自然科学基金项目(2018A030313533);广州市科技计划项目(201707010156);广东省医学科学技术研究基金项目(A2020140)。

摘　　要：目的探讨冠心病患者动脉粥样非钙化斑块的影响因素。方法选取2019年10月至2020年6月于本院心内科就诊并经冠状动脉计算机断层血管造影(CTA)检查发现有冠状动脉粥样硬化斑块的患者157例(男74例,女83例,平均年龄72.12岁),根据CT检查分为钙化斑块组(75例)和非钙化斑块组(82例)。采用独立样本t检验比较两组间的年龄、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)的差异;采用χ2检验比较两组间的性别、吸烟、高血压、糖尿病、家族史的差异;采用logistic回归分析分析冠状动脉粥样硬化斑块钙化程度的影响因素。结果非钙化斑块组年龄、高血压、家族史及TC、TG、LDL-C水平分别为(75.9±8.7)岁、80.5%(66/82)、52.4%(43/82)及(5.81±1.12)mmol/L、(2.36±1.03)mmol/L、(3.51±1.20)mmol/L,均高于钙化斑块组(67.2±10.1)岁、46.7%(35/75)、18.7%(14/75)及(4.84±1.05)mmol/L、(1.52±0.73)mmol/L、(2.91±0.71)mmol/L,HDL-C水平为(1.24±0.41)mmol/L,显著低于钙化斑块组(1.97±0.62)mmol/L,差异均有统计学意义(均P<0.05);而两组冠状动脉粥样硬化斑块患者性别、吸烟及糖尿病比较,差异均无统计学意义(均P>0.05)。在对年龄、性别、吸烟、高血压、糖尿病、家族史混杂因素进行校正后,logistic回归分析结果显示TC(OR=3.451,P<0.05)、LDL-C(OR=3.128,P<0.05)是危险因素,HDL-C(OR=0.099,P<0.05)是保护因素。逐步logistic回归分析结果显示年龄(OR=1.121,P<0.05)、TC(OR=2.429,P<0.05)、HDL-C(OR=0.079,P<0.05)、家族史(OR=6.351,P<0.05)是非钙化斑块的影响因素。结论HDL-C是冠心病患者非钙化斑块的保护因素,而TC、LDL-C是危险因素。Objective To investigate the influencing factors of atherosclerotic noncalcified plaques in patients with coronary heart disease.Methods A total of 157 patients with coronary atherosclerotic plaques diagnosed by transcoronary computed tomography angiography(CTA)in the Department of Medicine-Cardiovascular of our hospital from October 2019 to June 2020 were selected,including 74 males and 83 females,with an average age of 72.12 years old.They were divided into a calcified plaque group(n=75)and a noncalcified plaque group(n=82)based on the CT examination results.The differences of age,total cholesterol(TC),triglycerides(TG),high density lipoprotein cholesterol(HDL-C),and low density lipoprotein cholesterol(LDL-C)between the two groups were compared by the independent sample t test.The differences of gender,smoking,hypertension,diabetes,and family history between the two groups were compared by chi-square test.Logistic regression analysis was used to analyze the influencing factors of calcification degree of coronary atherosclerotic plaques.Results The age,hypertension,and family history,and levels of TC,TG,and LDL-C in the noncalcified plaque group were(75.9±8.7)years old,80.5%(66/82),52.4%(43/82),(5.81±1.12)mmol/L,(2.36±1.03)mmol/L,and(3.51±1.20)mmol/L,which were all higher than those in the calcified plaque group[(67.2±10.1)years old,46.7%(35/75),18.7%(14/75),(4.84±1.05)mmol/L,(1.52±0.73)mmol/L,and(2.91±0.71)mmol/L],and the level of HDL-C was lower than that in the calcified plaque group[(1.24±0.41)mmol/L vs.(1.97±0.62)mmol/L](all P<0.05);there were no statistically significant differences in the gender,smoking,and diabetes between the two groups(all P>0.05).After adjusting for age,gender,smoking,hypertension,diabetes,and family history,logistic regression analysis showed that TC(OR=3.451,P<0.05)and LDL-C(OR=3.128,P<0.05)were the risk factors and HDL-C(OR=0.099,P<0.05)was a protective factor.Stepwise logistic regression analysis showed that age(OR=1.121,P<0.05),TC(OR=2.429,P<0.05),HDL-C(OR=0.079,P<0.05)

关 键 词：动脉粥样硬化 血脂 斑块 影响因素 

分 类 号：R543.5[医药卫生—心血管疾病] R541.4[医药卫生—内科学]