冠心病病人代谢综合征的现况调查

Cross-sectional study on the prevalence of metabolic syndrome in patients with coronary heart disease in China

目的探讨中国冠心病病人代谢综合征(MS)的流行状况。方法选取中国北方城市(北京市、天津市),中部城市(上海市、南京市、杭州市、武汉市)和南方(广州市)城市共7个城市52家三级甲等医院为合作研究中心,其心内科2005年6月1日至2005年9月31日间所有符合冠心病诊断纳入标准的住院病人连续人选为研究对象,共收集有效病例3513例。调查内容包括:人体测量学资料、冠心病诊断情况、危险因素、糖代谢状况和血脂代谢状况。结果根据中华医学会糖尿病分会的MS诊断标准,冠心病病人MS患病人数为1064例(30．4％),男女分别为638例(27．4％)和426例(36．4％)。冠心病病人不同入院方式和不同冠心病种类之问MS的患病率差异无统计学意义(P= 0．139,0．446)。另外,北、中、南部城市冠心病病人的MS患病人数为576例(36．5％)、375例(25．5％)和113例(5．1％)。趋势检验显示由北向南呈现降低趋势(X2=50．252,P<0．001)。趋势X2检验,冠心病病人中MS的患病率有明显的年龄趋势,随着年龄的增加MS患病率有增加的趋势(X2=23．625,P<0．001)。MS患病率在60岁之前都是男性高于女性,60岁后则女性高于男性,而且上升速度快。结论我国冠心病病人中MS的患病率较高。防治MS对冠心病的发展、预后有着极其重要的意义。

Objective To investigate the prevalence of metabolic syndrome （MS） in the patients with coronary heart disease （CHD） in China. Methods The clinical data, including anthrometric data, case record form （ CRF）, clinical examination, etc. of all CHD patients hospitalized from 1 Jun 2005 to 31 Sep 2005 in the department of cardiology of 52 hospitals in 7 northern, middle, and southern cities in China, A total of 3513 CHD patients, 2341 males and 1172 females, aged 23 -99, were recruited. Results The prevalence of MS was 30, 4% among the 3513 CHD patients, 27.4% among the males and 36. 4% among the females. The prevalence of MS among the CHD patients in the northern cities was 36.5%, significantly higher than those in the middle and southern cites （25% and 25.1% respectively, x^2 = 50.252,P 〈0. 001 ）, with a trend to gradually decrease from north to south, The prevalence of MS among the CHD patients receiving acute admission was 28.8%, not significantly different from that receiving scheduled admission （31.2% , P=0. 139）, There was a clear age-related increase in the prevalence of MS （ x^2 =23. 625 ,P 〈0. 001 ）, The prevalence of MS of the males aged 〈 60 was higher than that of the females aged 〈60; and the prevalence of MS of the females aged 〉60 was higher than that of the females aged 〉 60. Conclusion The prevalence of MS in CHD patients is rather high in China. It is important to screen for MS in patients with high risk for new vascular incidents.