房颤合并冠心病患者冠脉病变支数的影响因素  

Influence factors affecting the number of coronary artery lesion branches in patients with atrial fibrillation combined with coronary artery disease

作　　者：陈雨莎 刁晓艳 CHEN Yusha;DIAO Xiaoyan(Department of Cardiovascular Medicine,the Affiliated Hospital of Guizhou Medical University,Guiyang 550004,Guizhou,China;School of Clinical Medicine,Guizhou Medical University,Guiyang 550004,Guizhou,China)

机构地区：[1]贵州医科大学附属医院心血管内科,贵州贵阳550004 [2]贵州医科大学临床医学院,贵州贵阳550004

出　　处：《贵州医科大学学报》2024年第4期603-608,共6页Journal of Guizhou Medical University

基　　金：贵州省科技厅项目(黔科合LG字[2012]049);贵阳市科学技术局基金项目(筑科合同[2019]9-1-15)。

摘　　要：目的探讨影响心房颤动(AF)合并冠心病(CAD)患者冠脉病变支数的相关危险因素。方法选取AF合并CAD患者330例作为研究对象,根据血管病变支数分为1支血管病变组(n=122)、2支血管病变组(n=95)及3支血管病变组(n=113),比较3组患者的性别、年龄、吸烟史、饮酒史、心力衰竭、高血压、糖尿病、慢性阻塞性肺疾病(COPD)、脑血管病史、血脂异常情况、外周动脉疾病、慢性肾衰竭、体质量指数(BMI)、尿酸、肌酐、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、空腹血糖、脑利钠肽前体(NT-Pro BNP)、非瓣膜病性心房颤动患者发生脑卒中的危险评分(CHA2DS2VASc)、心功能分级、院前口服用药情况;将有差异的指标纳入有序logistic多因素回归,分析影响AF合并CAD患者冠脉病变支数的危险因素。结果与1支血管病变组比较,3支血管病变组患者的男性占比、LDL-C、空腹血糖升高,差异有统计学意义(P<0.05);2支血管病变组患者的糖尿病占比升高,差异有统计学意义(P<0.05);进一步有序logistic回归分析表明男性发生多支血管病变的风险为女性的1.904倍(P=0.004),LDL-C每升高1 mmol/L、发生多支血管病变的风险也逐级递增(P=0.001)。结论LDL-C是AF发生多支血管病变的独立危险因素;相比女性,男性与冠脉多支血管病变的相关性更强。Objective To investigate the risk factors affecting the number of coronary lesion branches in patients with atrial fibrillation(AF)complicated with coronary artery disease(CAD).Methods A total of 330 patients with AF complicated with CAD were selected as research subjects.According to the number of vascular lesion branches,the patients were divided into 1-vascular lesion branch group(n=122),2-vascular lesion branch group(n=95)and 3-vascular lesion branch group(n=113).The following items were compared among three groups,including gender,age,smoking history,drinking history,heart failure,hypertension,diabetes mellitus,chronic obstructive pulmonary disease(COPD),cerebrovascular history,dyslipidemia,peripheral artery disease,chronic renal failure,body mass index(BMI),uric acid,creatinine,total cholesterol(TC),triglycerides(TG),high-density lipoprotein(HDL-C),low-density lipoprotein cholesterol(LDL-C),fasting blood glucose,NT Pro BNP,CHA2DS2-VASc score,cardiac function grade,and orally taken medication before hospitalization.Differentiated indicators were incorporated into ordered logistic multivariate regression to analyze the risk factors affecting the number of coronary artery lesion branches in patients with AF combined with CAD.Results When compared with 1-vascular lesion branch group,the proportion of males,LDL-C and fasting blood glucose were significantly increased in 3-vascular lesion branch group(P<0.05).The proportion of diabetes in 2-vascular lesion branch group was increased(P<0.05).Ordered logistic regression analysis showed that males were 1.94 times the risk of developing multiple vascular lesion branches of females(P=0.004),and the risk of developing multiple vascular lesion branches was gradually increased for every 1 mmol/L increase in LDL-C(P<0.001).Conclusion LDL-C is an independent risk factor for multiple vascular lesion branches in AF.When compared to females,males have a stronger correlation with multiple coronary vascular lesion branches than females have.

关 键 词：心房颤动 冠心病 冠状动脉病变 危险因素 低密度脂蛋白 男性 

分 类 号：R541.4[医药卫生—心血管疾病]