我院冠状动脉造影患者冠状动脉病变及相关情况变化10年对比分析

Comparative analysis of coronary artery disease and relative factors in patients underwent coronary arteriongraphy by the Nanfang Hospital between two periods over the past 10 years

目的:探讨我院(南方医科大学南方医院)10年前后冠状动脉造影患者临床诊断、冠状动脉病变情况及诊断冠心病患者的心血管危险因素的变化。方法:对照分析我院1995年7月至1996年12月行冠状动脉造影的156例和2004年7月至2005年12月行冠状动脉造影的257例患者,比较其在临床诊断及冠状动脉病变及病变支数的变化情况,其中分别确诊冠心病90例和174例,对比两组间在性别、年龄、冠心病家族史、吸烟史、体重指数、高血压病、糖尿病、血脂异常、高尿酸血症等危险因素的变化情况。结果:(1)两组间临床诊断的比较得出,2004-2005年组冠状动脉造影患者急性心肌梗死病例所占比例显著增高,两组间差异具有统计学意义(P=0.037)。(2)两组间冠状动脉病变的比较得出,2004-2005年组诊断冠心病病例显著增加(P=0.040)。(3)两组诊断为冠心病病例危险因素间的比较发现,与10年前相比,年龄构成中<60岁患者所占的比例显著增加,>70岁病人所占比例显著减少(P<0.001);合并糖尿病的发生率显著增高(P=0.006),合并高血压病的发生率显著降低(P=0.012)。结论:同10年前相比,冠状动脉造影病例的临床诊断呈加重趋势,急性心肌梗死病例显著增加;冠状动脉造影诊断为冠心病的病例显著增多;年龄构成上呈低龄化;冠心病合并2型糖尿病的发生率显著增高;合并高血压病的发生率显著降低。冠状动脉造影患者的上述变化值得临床关注。

Objective To investigate the variation of clinical diagnosis,the severity of coronary artery disease and risk factors in patients underwent coronary arteriongraphy by the Nanfang Hospital（the First Affilliated Hospital of Nan.fang Medical University）between two periods over the past 10 years. Methods One hundred and fifty-six cases from july 1995 to December 1996 and 257 cases from July 2004 to December 2005 underwent coronary arteriongraphy were selected in this study. Their clinical diagnosis and the severity of coronary artery disease were retrospectively analyzed. Ninety patients from the 156 patients and 174 patients from the 257 patients finally diagnosed coronary artery disease were compared the variation of cardiovascular risk factors including gender, age, coronary artery disease family history, smoking status, body mass index, hypertensive disease, diabetes mellitus, dyslipidemia, and high uric level. Results During the period, （ 1 ） The proportion of acute myocardial infarction increased from 12.2% to 24. 1% （ P = 0. 037）; （2） The proportion of diagnosed coronary artery disease increased from 57.7% to 67, 7% （ P =0. 040）; （3） It showed by comparing the cardiovascular risk factors in the patients of diagnosed angiographie coronary artery disease that the proportion of age lower than 60 increased significantly but the proportion of age higher than 70 decreased significantly（ P 〈0. 001）and the incidence of diabetes mellitus increased from 14. 4% to 28.7% （P=0. 006）, whereas the incidence of hypertensive disease decreased from 71. I% to 54. 6% （ P = 0. 012） now. Conclusions Comparing with 10 years before, the study shows that the acute myocardial infarction cases in patients underwent coronary arteriongraphy increase significantly, the patients diagnosed angiographic coronary artery disease increase significantly, age of the patients diagnosed angiographic coronary artery disease is tend to lower, the incidence of diabetes mellitus increases significantly whereas the incidence of hypertensive disease decreases significantly.