川中地区早发冠心病患者的危险因素及冠状动脉病变特点  

Risk factors of premature coronary heart disease and features of coronary lesions in patients in the central region of Sichuan

作　　者：罗倩 刘磊 李双 刘益均[1] 任宏强 谭震 LUO Qian;LIU Lei;LI Shuang;LIU Yijun;REN Hongqiang;TAN Zhen(Department of Cardiology,Suining Central Hospital,Suining,Sichuan,629000,China)

机构地区：[1]遂宁市中心医院心内科,四川遂宁629000

出　　处：《临床心血管病杂志》2024年第3期207-211,共5页Journal of Clinical Cardiology

摘　　要：目的:探讨川中地区早发冠心病患者的临床危险因素及冠状动脉(冠脉)病变特点。方法:采用回顾性病例对照研究方法,收集2020年11月—2022年6月就诊于遂宁市中心医院行冠脉造影检查的患者603例,其中早发冠心病患者163例(早发冠心病组)、非早发冠心病患者240例(非早发冠心病组)、非冠心病患者200例(非冠心病组)。记录并比较各组患者一般资料、生化指标和冠脉造影结果,采用SYNTAX评分评估患者冠脉病变。采用多因素logistic回归分析早发冠心病的临床危险因素。结果:与非早发冠心病组患者比较,早发冠心病组女性、吸烟史、早发冠心病家族史比例显著升高(均P<0.05),中性粒细胞、低密度脂蛋白胆固醇(LDL-C)、甘油三酯(TG)水平显著升高(均P<0.05)。多因素logistic回归分析显示,男性(OR=5.421,95%CI:2.687~11.47,P<0.001)、中性粒细胞计数(OR=1.706,95%CI:1.469~2.017,P<0.001)、LDL-C(OR=1.350,95%CI:1.004~1.826,P=0.048)、空腹血糖(OR=1.213,95%CI:1.106~1.353,P<0.001)、室间隔厚度(OR=1.251,95%CI:1.052~1.498,P=0.012)、年龄(OR=1.161,95%CI:1.095~1.237,P<0.001)是早发冠心病的独立危险因素,左室射血分数(LVEF)是保护性因素(OR=0.915,95%CI:0.876~0.951,P<0.001)。在病变特征方面,早发冠心病组急性心肌梗死比例增加(45.4%vs 59.5%,P=0.007),单支病变比例显著升高(26.7%vs 40.5%,P=0.005),前降支病变比例(90.8%vs 75.5%,P<0.001)和SYNTAX评分水平显著降低[11.00(7.00,16.50) vs 9.00(6.00,13.50),P<0.001]。结论:男性、中性粒细胞、LDL-C、空腹血糖、室间隔厚度、年龄是川中地区患者早发冠心病的独立危险因素;早发冠心病患者的冠脉病变以单支病变较多,起病方式多为急性心肌梗死,其血管病变复杂程度低于非早发冠心病患者。Objective:To explore risk factors of premature coronary heart disease(PCHD) and features of coronary lesions in patients in the central region of Sichuan.Methods:This is a retrospective case-control study.A total of 603 patients who underwent coronary angiography at Suining Central Hospital from November 2020 to June 2022 were collected.All patients were divided into the PCHD group(n=163),non-PCHD group(n=240),and non-CHD group(n=200).The baseline data including general information,biochemical indicators,and coronary angiography results were collected and compared.Coronary artery disease was measured by SYNTAX score.Multivariate logistic regression analysis was performed to assess risks of PCHD.Results:Compared with the non-PCHD group,the proportion of female,smoking history,and family history of PCHD in the PCHD group were significantly increased(all P<0.05),and the levels of neutrophil,low-density lipoprotein cholesterol(LDL-C),and triglyceride(TG) were significantly increased(all P<0.05).Multivariate logistic regression analysis showed that male(OR=5.421,95%CI:2.687-11.47,P<0.001),neutrophil count(OR=1.706,95%CI:1.469-2.017,P<0.001),LDL-C(OR=1.350,95%CI:1.004-1.826,P=0.048),fasting blood glucose(OR=1.213,95%CI:1.106-1.353,P<0.001),interventricular septal thickness(OR=1.251,95%CI:1.052-1.498,P=0.012),and age(OR=1.161,95%CI:1.095-1.237,P<0.001) were independent risk factors for PCHD,left ventricular ejection fraction(LVEF) was a protective factor(OR=0.915,95%CI:0.876-0.951,P<0.001).In the PCHD group,the proportion of acute myocardial infarction(45.4% vs 59.5%,P=0.007) and single-vessel lesion(26.7% vs 40.5%,P=0.005) significantly increased,and the proportion of left anterior descending vessel lesion(90.8% vs 75.5%,P<0.001) and SYNTAX score[11.00(7.00,16.50) vs 9.00(6.00,13.50),P<0.001]significantly decreased.Conclusion:Male,neutrophil,LDL-C,fasting blood glucose,interventricular septal thickness,and age are independent risk factors for PCHD in patients in the central region of Sichuan.In patients with PCHD,there

关 键 词：冠心病 危险因素 冠状动脉病变 

分 类 号：R541.4[医药卫生—心血管疾病]