老年退行性心脏瓣膜病与冠心病关系的研究

The study of the relationship between senile degenerative heart valvular disease and coronary artery disease

目的:探讨年龄≤65岁的患者中,老年退行性心脏瓣膜病(SDHVD)与冠心病之间的关系。方法:298例年龄≤65岁患者(其中122例年龄≤55岁,176例年龄>55岁)同时进行冠状动脉造影检查和超声心动图检查。结果:①随着SDHVD钙化部位数的增加,患者年龄(P<0.01)、高血压(P<0.001)和糖尿病(P<0.05)的发病率均呈进行性增加;②随着SDHVD钙化部位数的增加,冠状动脉造影阳性的发生率逐渐增加(P<0.001);③多因素Logistic回归分析发现,SDHVD是冠心病有价值的预测因子之一(P<0.01),且预测力大于年龄(P<0.05)和高脂血症(P<0.05);对于女性患者和年龄≤55岁患者而言,SDHVD仍然是冠心病有价值的预测因子(P<0.05,P<0.001),而对于男性和年龄>55岁患者而言,则无预测价值(P>0.05)。结论:SDHVD可作为冠心病的预测因子,且钙化部位数越多,其预测价值越大。

Objective： To determine whether there is an relation between senile degenerative heart valvular disease（SD- HVD） with coronary artery disease （CAD） in subjects age≤65 years old. Methods： The age of the 298 patients were ≤65 years old. All patients underwent transthoracic echocardiography and coronary arteriography at the same time. Results： （1）There was a progressive increase incidence of hypertension（P〈0.001） and diabetes（P〈0.05） with an increasing rate of calcium deposits of SDHVD as increase in age （P〈0.001）. （2）With an increasing sites with calcium deposits of SDHVD, there was a progressive increase in positive results of coronary arteriography （P〈0.001）. （3）Multiple logistic analyses identified SDHVD as significant predictors for the positive prevalence of coronary arteriography （P〈0.01）. In female patients and age ≤55 years, SDHVD was statistically significant predictors of the positive prevalence of coronary arteriography （P〈0.001, P〈0.05, respectively）. Conclusions： There is a significant relation between SDHVD and coronary artery disease. The presence of SDHVD is an independent predictor of coronary artery disease.