早发冠心病患者的危险因素及冠脉病变特点研究

Study on the risk factors and coronary lesion features in patients with premature coronary artery disease

目的探讨早发冠心病患者的危险因素及冠脉病变特点。方法收集2009年1月至2013年1月来郑州大学第一附属医院心内科采用judkins法行冠状动脉造影的620例患者为研究对象,根据冠状动脉造影的检查结果将其分为早发组(n=286,早发冠心病者)、晚发组(n=184,晚发冠心病者)、对照组(n=150,非冠心病者)三组。对三组患者的临床资料与临床指标进行统计学分析,采用logistic回归分析早发冠心病患者的危险因素,并比较早发组与晚发组的冠状动脉特点。结果晚发组、对照组在部分基线资料及部分临床指标上与早发组相比(P<0.05)。以对照组为参照进行logistic回归分析,结果高血压、2型糖尿病、肥胖、吸烟及早发冠心病家族史是早发冠心的独立危险因素,(均P<0.01,95%CI>1)。早发组的单支病变比例明显高于晚发组(χ2=10.998,P=0.001);而左回旋支、右冠状动脉的比例则明显低于晚发组(χ2=14.442,9.807,P=0.00,0.002)。Gensini积分越高表明冠脉病变程度越严重,晚发组在56-85和>85阶段的Gensini积分明显高于早发组,经比较(t=2.601,5.290,P=0.010,0.000)。结论高血压、2型糖尿病、肥胖、吸烟及早发冠心病家族史是早发冠心的独立危险因素。早发冠心病患者单支冠状动脉病变多于晚发,且冠脉病变程度较轻。

Objective To investigate the characteristics of risk factors in patients with premature coronary heart dis-ease and coronary artery disease.Methods 620 casesfrom 2009January to2013January in the department of Cardiology, the First Affiliated Hospital of Zhengzhou University Judkins methodin patients undergoing coronary angiographyas the research object,according to coronary angiographyexaminationwere divided intothe early group（n=286,prematurecoronary heart diseasegroup（n=184）,late,latecoronary heart disease）,control group（n=150,nonCHDgroup）three.Statistical analysis was madeon theclinicaldata of threepatientswith clinical parameters,using logistic regressionanalysis of riskfactorsin patients with prematurecoronary heart disease,coronary arteryand compare the characteristicsof early-group and late onsetgroup.Results The late-onset group,the control group in some baseline data and some clinical indexes and early-onset group（P 〈0.05）.In the control group as a reference to logistic regression analysis,the results of hypertension,type 2 diabetes,obesity,smoking and family history of premature coronary heart disease is an independent risk factor for premature coronary heart,（P 〈0.01,95%CI〈 1）.Single branch lesion proportion of early-onset group was significantly higher than the late group（χ2 =10.998,P =0.001）;and the left circumflex artery,right coronary ar-tery ratio was significantly lower than the late group（χ2 = 14.442,9.807,P = 0.00,0.002）.The higher the Gensini score showed that the more severe coronary artery stenosis,late onset group in 56-85 and？〉 Gensini integral 85 stage was significantly higher than thatof the early group,by comparison（t=2.601,5.290,P =0.010,0.000）.Conclusion hypertension,type 2 diabetes,obesity,smoking and family history of premature coronary heart disease is an independent risk factor for premature coronary heart.Premature coronary artery disease in patients with single vessel coronary artery lesions than the late,and the severity of coronary artery lesions lighter.