冠状动脉病变长度的相关因素

Risk factors of coronary artery length lesions

目的 :探讨冠状动脉长病变的相关因素。方法 :将冠状动脉造影 (CAG)确诊的 15 6例冠心病 (CHD)患者 ,按病变长度分为A型病变组 (A组 ) 5 4例 ;B型病变组 (B组 ) 5 0例 ;C型病变组 (C组 ) 5 2例。设计统一的调查表 ,对患者的社会经济文化背景 ,临床表现 ,CHD常见危险因素以及CAG进行调查和测量 ,比较组间差异 ,并对病变长度与相关因素进行相关和回归分析。结果 :心肌梗死和不稳定型心绞痛发生率 ,组间比较差异显著 (P <0 .0 5、P <0 .0 1) ,C组发生率最高 ,且多支病变为主 (P <0 .0 1) ;稳定型心绞痛 ,组间比较差异非常显著 (P <0 .0 1) ,A组发生率最高 ,主要为单支病变 (P <0 .0 1)。病变长度 ,组间差异非常显著 (P <0 .0 1) ;B ,C组年龄显著大于A组 (P <0 .0 5 ) ,病程显著长于A组 (P <0 .0 1) ,血糖 (FBG)、中性粒细胞计数 (PMN)、C反应蛋白 (CRP)均高于A组 (P <0 .0 1) ;另外C组吸烟指数 (CSI)高于A、B组 ,而射血分数 (EF)低于A、B组 (P <0 .0 1)。长病变分别与年龄、病程、CSI、EF、FPG、PNN、CRP具有相关性 ,统计学上有非常显著的意义 (P <0 .0 1) ,长病变与年龄及病程在不同组中有相依变动的规律 (P <0 .0 1)。结论 :稳定型心绞痛冠脉多是单支的A型病变改变 ,不稳定型心绞痛或心肌梗死冠脉主要为?

AIM:To investigate the correlation of coronary artery length lesions by coronary arteriography(CAG) with risk factors of coronary heart disease(CHD). METHODS: 156 patients with CHD diagnosed by CAG were investigated. According to the length of the coronary artery lesions, they were divided into 3 groups: A type group(n=54), B type group(n=50), C type group(n=52).Their serum lipids were all measured and their CAG was all performed. Design the graph to study the relation between the CHD and the major risk factors such as the background of social economic culture, clinical situation, common CHD risk factors and CAG etc. Compare them with linear correlation and regression analysis. RESULTS: The differences were observed among groups of morbidity(P<0.05), The myocardial infarction in C type group was 42.3%, The unstable angina was 42.2%. And the stable angina in A type group was 64.8%. The age and duration of all patients in B and C type group were obvious longer than in A type group(P<0.01). Fasting plasma glucose(FPG) or C-reactive protein (CRP) or polymorphonuclear neutrophils(PMN)in B and C type group were higher than in A type group (P<0.05), Cigarette smoking index(CSI) in C type group was higher than in A and B type group(P<0.05). Ejection fraction (EF) in C type group was lower than the other two group(P<0.05). It showed the linear correlation between the length lesion and the risk factors such as the age, the duration, CSI, FPG, PMN, EF, CRP etc (P<0.01). It also showed the linear regression between the length lesion and the factors of the age and the duration (P<0.01). CONCLUSION:Stable angina happened mostly in those with singlevessel of type A lesion, while the myocardial infarction or unstable angina happened mostly in those with mutivessel of type C lesion. the length of coronary artery lesion was influenced by the factors of the age, duration, CSI, FPG, PMN, EF, and CRP in some extent. It might be meaningful for clinical doctors to study the course of myocardial ischemia and (or) angina pectoris, and we could alse get ideas about the clinical stability of the coronary artery lesion .