冠状动脉病变程度与冠心病危险因素的关系

The relationship between classification of coronary artery lesion and risk factors of coronary artery disease

目的研究冠状动脉病变严重程度与冠心病各类易患因素,尤其是血糖水平的关系,阐明这些因素对冠心病不同阶段、不同性质的影响。方法采用自行设计的“冠状动脉粥样硬化性心脏病及血糖现状报告表”,自2005年5-9月从同济医院心内科、CCU住院患者中,选择已行冠状动脉造影术(CAG)者共计175人,分为对照组、陈旧性心肌梗死组(OMI)、不稳定型心绞痛组(UAP)和急性心肌梗死组(AMI),进行详细问卷调查,抽取空腹静脉血检测一般临床指标和口服葡萄糖耐量试验(OGTT),对所获各类数据指标及血糖水平进行统计学分析。结果男性在OMI和AMI组中占多数;AMI组高血压患病率、平均收缩压(SBP)、心脏病罹患年数、体重指数(BMI)均高于其余各组;AMI组血肌酐、OGTT120 min、LDL-C/HDL-C、TG/LDL-C、HDL-C,UAP组空腹血糖与其余各组相比,差异有显著性(以上P<0.05或0.01)。结论在经血管造影明确诊断的冠心病患者,随着冠状动脉病变严重程度的逐渐增加,往往合并多种冠心病危险因素。对有以上病史的可疑冠心病患者,进行一、二级预防的同时,更要重视高血压、高脂血症尤其是糖尿病的早期诊治。

Objective To explore the relationship between the severity of coronary artery lesions and variable risk factors of coronary artery diseases （CAD） and to elucidate the effect of these factors on different stages of CAD. Methods By using self-designed questionnaire, 175 cases definitely diagnosed as CAD were selected and divided into 4 groups： control group, old myocardial infarction group（OMI）, unstable angina pectoris group （UAP） and acute myocardial infarction group （AMI）. Fasting vein blood samples were taken to measure general clinical indices and oral glucose tolerance test was also undertaken. Results The number of male patients was higher in OMI and AMI groups than that of female patients. The morbidity of essential hypertension, systolic blood pressure, years of CAD, body mass index were all higher than those of other groups. Serum creatinine, OGTT 120 min, LDL/HDL,TG/LDL,HDL-C and fasting blood glucose were significantly higher than those of other groups （ P 〈 0.05 or 0.01 ）. Concision As to CAD patients precisely diagnosed by cardioangiography, the number of CAD risk factors gradually increased corresponding to lesion degree of coronary artery. Precaution and treatment of diabetes, hypertension and hyperlipidemia of suspected CAD patients maybe as much important as primary and secondary prevention.