413例冠脉造影患者危险因素与冠脉病变的相关性研究

Relationship between coronary artery disease and cardiovascular risk factors in 413 patients underwent coronary angiography

目的：探讨冠脉造影患者心血管危险因素与冠脉病变的相关性。方法：对于南方医院住院的2004年6月至2008年12月的413例行冠脉造影患者，采集病历数据，包括性别、年龄、体重指数、吸烟、高血压病、2型糖尿病、低密度脂蛋白-胆固醇（LDL-C）、高密度脂蛋白-胆固醇（HDL-C）、甘油三酯（TG）、尿酸（UA）、纤维蛋白原（Fg）、C-反应蛋白（CRP）及血清总胆红素（TBIL）等指标，冠脉造影通过直径目测法判断是否患冠心病。以单因素分析心血管危险因素与冠脉病变的关系，采用多因素Logistic回归分析筛选冠心病的独立相关危险因素。结果：（1）冠心病组患者男性比例、平均年龄、体重指数、LDL-C、TG、UA、CRP、Fg水平均显著高于非冠心病组，HDL-C水平显著低于非冠心病组，合并吸烟、高血压、糖尿病的病例显著多于非冠心病组（P〈0．05～〈0．01）；（2）Logistic回归分析显示，LDL-C、吸烟、糖尿病、高血压、体重指数、HDL-C、增龄、高尿酸入选回归方程（OR=3．559～1．003，P〈0．05～〈0．001），其中LDL-C为最显著的独立相关出素（OR：3．559，95％可信区间2．143～5．911，P〈0．001）。结论：LDL-C水平升高、吸烟、糖尿病、高血压、体重指数上升、HDH—C水平降低、增龄、高尿酸水平为冠心病的显著，独立相关因素。

Objective： To evaluate the correlation of coronary artery disease （CAD） with cardiovascular risk factors in patients underwent coronary angiography （CAG）. Methods： The 413 patients during July 2004 to December 2006 underwent GAG were selected according to inclusion criteria. CAD was diagnosed by measuring the stenosis of vessels diameter ≥50G while CAG. Cardiovascular risk fact-ors included were gender, age, body mass index （BMI）, hypertension disease, smoking status, type 2 diabetes mellitus （DM）, low-density lipoprotein cholesterol （LDL-C）, highdensity lipoprotein-cholesterol （HDL-C）, triglyceride （TG）, uric acid （UA）, fibrinogen （Fg）, C- reactive protein （CRP） and serum total bilirubin （TBIL） level. Analyses were achieved by univariate and multivariate analysis. Results： （1） Comparing with the non-CAD control group, the patients of CAD group had higher male proportion, smoking cases, higher average age, higher level of LDL-C, TG, BMI, UA, CRP, Fg, lower level of HDL-C and higher incidence of combining type 2 diabetes mellitus and hypertension disease （P〈0.05～〈0.01）. No significant difference were found in the level of TBIL between the two groups; （2） Logistic regression analysis showed that LDL- C, smoking, type 2-DM, hypertension disease, BMI, lower HDL-C, aging, UA were the prominent predictor of CAD （OR=3. 559～1. 003, P〈0.05～〈0. 001） and LDL-C was the most important risk factor （OR=3. 559, 95G C. I. 2. 143～5. 911, P〈0. 001）. Conclusion： The results suggest that the LDL-C, smoking, type 2 DM, hypertension disease, BMI, lower HDL-C, aging, and UA are the prominent predictor of CAD.