老年女性冠状动脉微血管疾病患者危险因素分析  

Risk factors for coronary microvascular disease in elderly female patients

作　　者：窦敏 薛力旗 单迎光[1] 李一鸣 秦小飞[1] Dou Min;Xue Liqi;Shan Yingguang;Li Yiming;Qin Xiaofei(Department of Cardiovascular Diseases,the First Affiliated Hospital of Zhengzhou University,,Zhengzhou 450052,Henan Province,China)

机构地区：[1]郑州大学第一附属医院心血管内科,450052

出　　处：《中华老年心脑血管病杂志》2023年第10期1012-1015,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：河南省科技计划项目(182102310303)。

摘　　要：目的探讨老年女性冠状动脉微血管疾病(CMVD)患者的危险因素。方法回顾性连续收集2020年9月至2022年6月就诊于郑州大学第一附属医院行冠状动脉造影及冠状动脉血流储备(CFR)检查的老年女性患者109例,根据CFR值诊断冠状动脉CMVD,并将其分为CMVD组(CFR<2.0)55例和非CMVD组(CFR≥2.0)54例,比较2组临床基线资料并分析与CMVD相关的影响因素。结果与非CMVD组比较,CMVD组体质量指数、尿酸、高敏C反应蛋白(hs-CRP)、TG、LDL-C、脂蛋白相关磷酸酶A2(Lp-PLA2)显著升高,HDL-C降低,差异有统计学意义(P<0.05,P<0.01)。Spearman相关性分析显示,Lp-PLA2、hs-CRP与CFR呈负相关(r=-0.816;r=-0.399,P<0.01)。Logistic回归分析显示,hs-CRP、Lp-PLA2水平升高是老年女性患者发生CMVD的独立危险因素(P<0.05);ROC曲线分析显示,Lp-PLA2诊断老年女性CMVD患者的曲线下面积为0.745(95%CI:0.655~0.836),敏感性为69.1%,特异性为67.0%,hs-CRP诊断老年女性CMVD患者的曲线下面积为0.752(95%CI:0.661~0.844)。结论老年女性CMVD患者的Lp-PLA2、hs-CRP水平较高,可预测冠状动脉CMVD发生的风险。Objective To investigate the risk factors of coronary microvascular disease(CMVD)in elderly female patients.Methods Clinical data of 109 consecutive female elderly patients who received coronary angiography and coronary flow reserve(CFR)in our hospital from September 2020 to June 2022 were retrospectively collected in this study.According to CFR value,they were divided into CMVD group(CFR<2.0,n=55)and non-CMVD group(CFR≥2.0,n=54).The basic clinical data were compared between the two groups,and influencing factors associated with CMVD were analyzed.Results Significantly higher BMI and elevated UA,hs-CRP,TG,LDL and Lp-PLA2 levels,while lower HDL level was observed in the CMVD group than the non-CMVD group(P<0.05,P<0.01).Lp-PLA2 and hs-CRP were negatively correlated with CFR(r=-0.816;r=-0.399,P<0.01).Spearman correlation analysis indicated that CRV value was negatively correlated with Lp-PLA2 and hs-CRP levels(r=-0.816,-0.399,P<0.01).Logistic regression analysis showed that hs-CRP and Lp-PLA2 were independent risk factors for CMVD in elderly female patients(P<0.05).ROC curve analysis revealed that the AUC value of Lp-PLA2 for diagnosing CMVD in elderly female patients was 0.745(95%CI:0.655-0.836),with a sensitivity of 69.1%and a specificity of 67.0%.And,the AUC value of hs-CRP was 0.752(95%CI:0.661-0.844).Conclusion Lp-PLA2 and hs-CRP levels are quite higher in elderly female CMVD patients,and can predict the occurrence of CMVD in elderly female patients.

关 键 词：冠状动脉疾病 血管造影术 危险因素 冠状动脉微血管疾病 

分 类 号：R541.4[医药卫生—心血管疾病]