心尖肥厚型心肌病患者冠心病的相关因素分析  

Correlative factors of coronary artery disease in patients with apical hypertrophic cardiomyopathy

作　　者：阮燕萍[1] 张磊 刘晓伟[1] 何怡华[1] Ruan Yanping;Zhang Lei;Liu Xiaowei;He Yihua(Center of Echocardiography Medicine,Beijing Anzhen Hospital,Capital Medical University,Beijing 100029,China.;不详)

机构地区：[1]首都医科大学附属北京安贞医院心脏超声医学中心,北京安贞医院胎儿心脏病母胎医学中心,北京100029 [2]中国人民解放军总医院京西医疗区综合内科,北京100043

出　　处：《中国循证心血管医学杂志》2023年第2期162-165,共4页Chinese Journal of Evidence-Based Cardiovascular Medicine

基　　金：国家重点研发计划(2018YFC1002300);胎儿心脏病母胎医学研究北京市重点实验室(BZ0308)。

摘　　要：目的分析心尖肥厚型心肌病患者(ApHCM)冠状动脉(冠脉)粥样硬化性心脏病(冠心病,CAD)的相关因素。方法连续入组2011年4月至2019年4月于首都医科大学附属北京安贞医院因胸痛入院治疗的心尖肥厚型心肌病患者125例,其中40例行冠脉CTA检查,85例行冠脉造影检查,其中确定冠脉狭窄≥50%者38例,该组为CAD组(观察组),平均年龄65.5岁,男性比例71.1%,其余87例为非CAD组(对照组),平均年龄60.3岁,男性比例为75.9%。收集患者年龄、性别、合并疾病、治疗及超声心动图检查结果,采用逐步Logistic回归分析评估ApHCM患者冠心病的相关因素。结果与非CAD组相比,CAD组年龄更大、高胆固醇血症比例、经皮冠脉介入治疗(PCI)比例更高(P<0.05)。与CAD组相比,非CAD组患者左室舒张末内径(LVEDD)更大、左室心尖部厚度更厚(P<0.05)。多因素Logistic逐步回归分析表明高胆固醇血症(OR=3.900,95%CI:1.698~8.961,P=0.001)、年龄(OR=1.048,95%CI:1.008~1.089,P=0.018)是该人群冠脉病变的独立危险因素。结论冠心病是影响ApHCM的关键因素之一,且发生率较高,而高胆固醇血症和年龄是冠脉病变的独立危险因素,对其积极控制尤为重要。Objective To analyze the correlative factors of coronary artery disease(CAD)in patients with apical hypertrophic cardiomyopathy(ApHCM).Methods The patients(n=125)with ApHCM hospitalized due to chest pain were chosen from Beijing Anzhen Hospital affiliated to Capital Medical University from Apr.2011 to Apr.2019.Among all patients,there were 40 cases received examination of computed tomographic angiography(CTA)and 85 cases received examination of coronary angiography(CAG).There were 38 cases confirmed with coronary artery stenosis≥50%and selected into group of coronary artery disease(CAD group,average aged=65.5,ratio of male cases 71.1%),and 87 cases without CAD selected into non-CAD group(average aged=60.3,ratio of male cases 75.9%).The data of age,gender,complicated by other diseases,therapies and results of echocardiogram were collected.The factors related to CAD were reviewed in ApHCM by using Logistic stepwise regression analysis.Results Compared with non-CAD group,the patients were older,and percentages of cases with hypercholesteremia and PCI were higher in CAD group(P<0.05).Compared with CAD group,left ventricular end-diastolic inner diameter(LVEDD)was larger and left ventricular apex thickness was thicker(P<0.05).The results of multi-factor Logistic stepwise regression analysis showed that hypercholesteremia(OR=3.900,95%CI:1.698~8.961,P=0.001)and age(OR=1.048,95%CI:1.008~1.089,P=0.018)were independent risk factors of coronary artery lesions in ApHCM patients.Conclusion CAD is one of key factors affecting ApHCM,and its incidence rate is relatively higher.Hypercholesterolemia and age are independent risk factors of coronary artery lesions.Therefore,it is particularly important to actively control these factors.

关 键 词：心尖肥厚型心肌病 冠心病 高胆固醇血症 

分 类 号：R541.4[医药卫生—心血管疾病]