冠状动脉瘤样扩张合并急性心肌梗死患者的危险因素分析  

Analysis of risk factors in patients with coronary artery aneurysm combined with acute myocardial infarction

作　　者：李文[1,2] 鲁兆娜 熊翔宇 孙洪波 王佳琪 吴校林 LI Wen;LU Zhaona;XIONG Xiangyu;SUN Hongbo;WANG Jiaqi;WU Xiaolin(School of Medicine,Wuhan University of Science and Technology,Wuhan,430000,China;Department of Cardiology,Xiangyang Central Hospital,Affiliated Hospital of Hubei College of Arts and Sciences,Institute of Cardiovascular Disease,Hubei College of Arts and Sciences)

机构地区：[1]武汉科技大学医学部医学院,武汉430000 [2]湖北文理学院附属医院襄阳市中心医院心血管内科,湖北文理学院心血管病研究所

出　　处：《临床心血管病杂志》2024年第10期821-825,共5页Journal of Clinical Cardiology

基　　金：湖北省卫生健康委青年人才项目(No:WJ2021Q013)。

摘　　要：目的:研究冠状动脉瘤样扩张(CAE)合并急性心肌梗死(AMI)患者的危险因素。方法:回顾性分析2017年1月—2023年12月在襄阳市中心医院心血管内科住院并实施冠状动脉(冠脉)造影的患者,并筛选出CAE患者170例,根据是否发生AMI分为CAE组(112例)和CAE+AMI组(58例)。比较两组患者的临床资料,进行Spearman相关性分析和logistic回归分析。结果:170例CAE患者中,单支CAE最常见,以右冠脉(RCA)受累最多(57支,占33.5%)。两组患者在吸烟史、抗血小板药物使用率、低密度脂蛋白胆固醇(LDL-C)、心肌肌钙蛋白I(cTnI)、肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、C反应蛋白(CRP)、白细胞计数(WBC)、中性粒细胞计数(Neu)、中性粒细胞与淋巴细胞比值(NLR)等方面存在显著差异(P<0.05)。Spearman相关性分析显示,LDL-C、CRP、WBC、Neu与cTnI、CK、CK-MB均呈正相关。Logistic回归分析显示,吸烟、抗血小板药物使用率低、高LDL-C以及CRP是CAE患者发生AMI的危险因素(P<0.05)。结论:吸烟、抗血小板药物使用率低、LDL-C以及CRP高是CAE患者发生AMI的危险因素。Objective To investigate the risk factors in patients with coronary aneurysmal dilation(CAE)complicated with acute myocardial infarction(AMI).Methods Retrospective analysis was performed on patients admitted to the cardiovascular Department of Xiangyang Central Hospital from January 2017 to December 2023 who underwent coronary artery angiography,and 170 CAE patients were screened out and divided into CAE group(112 cases)and CAE+AMI group(58 cases)according to whether AMI occurred.The clinical data of the two groups were compared.Spearman correlation analysis and logistic regression analysis were performed.Results In 170 CAE patients,single-vessel coronary angiomatous dilatation was the most common,and the right coronary artery(RCA)was the most involved(57 vessels,accounting for 33.5%).There were significant differences in smoking history,use rate of antiplatelet drugs,low density lipoprotein cholesterol(LDL-C),myocardial troponin I(cTnI),creatine kinase(CK),creatine kinase isoenzyme(CK-MB),C-reactive protein(CRP),white blood cell count(WBC),neutrophil count(Neu),and neutrophil to lymphocyte ratio(NLR)(P<0.05).Spearman correlation analysis showed that LDL-C,CRP,WBC,Neu were positively correlated with cTnI,CK,and CK-MB.Logistic regression analysis showed that smoking,low utilization rate of antiplatelet drugs,high LDL-C and CRP were risk factors for AMI in CAE patients(P<0.05).Conclusion Smoking,low utilization rate of antiplatelet drugs,high LDL-C and CRP are risk factors for AMI in CAE patients.

关 键 词：冠状动脉瘤样扩张 急性心肌梗死 危险因素 

分 类 号：R541.4[医药卫生—心血管疾病]