青年冠心病患者心血管病危险因素与冠状动脉病变程度的相关性分析

Study of the relationship between cardiovascular risk factors and severity in young patients with coronary artery disease

目的探讨青年冠心病患者心血管疾病危险因素与冠状动脉(冠脉)造影病变程度相关性。方法疑似青年冠心病患者(≤45岁)行冠脉造影住院病例91例,经冠脉造影确诊冠心病患者67例,排除冠心病患者24例。冠脉造影病变程度由病变支数和病变Gensini总积分表示。危险因素包括性别、高血压病、吸烟、饮酒、2型糖尿病、血脂异常、肥胖。采用单因素和多因素分析。结果(1)单因素分析显示,在病变程度不同的各组间比较,随各组中存在单个危险因素病例百分率的增加,冠脉造影病变支数和病变Gensini总积分随之增加。(2)多因素Logistic回归分析(前进法)显示,高LDL-C为冠脉造影诊断冠心病最显著的独立相关危险因素,其他危险因素依次为男性、吸烟、高血压病、2型糖尿病、低HDL-C、肥胖和饮酒。结论高LDL-C是冠脉造影诊断冠心病最显著的独立相关危险因素,但其他危险因素如男性、吸烟、饮酒、2型糖尿病、低HDL-C、高血压病和肥胖亦不可忽视,各危险因素在不同性别中危险程度有所不同。

Objective To evaluate the correlation between multiple cardiovascular risk factors and the severity of angiographic coronary artery disease（CAD） in young patients underwent coronary angiography. Methods Ninety one patients underwent coronary angiography were selected according to inclusion criteria. The extent and severity of angiographic CAD was diagnosed by ： （ 1 ） whether or not CAD was diagnosed by angiography; （2） the number of diseased vessels; （ 3 ） The CAD Gensini cumulative index. Cardiovascular risk factors included were gender, hypertension, smoking status, type 2 diabetes mellitus, dyslipidemia, adipositas and drinking status. Analyses were achieved by univariate and multivariate analysis. Results Logistic regression analysis showed that high low-density lipoprotein was a prominent pre- dictor of the extent and severity of angiographic CAD. Conclusion （ 1 ） It is very important to control risk factors in the intervention and prevention of CAD. （2）Distribution of risk factors and their severities vary in different genders, therefore the treatment of risk factors should be done differently.