冠状动脉狭窄及病变支数与相关危险因素的研究

Relation of risk factors to coronary artery stenosis severity in coronary atherosclerotic heart disease

目的 研究分析冠状动脉狭窄与高血压、糖尿病、吸烟、年龄、体重、尿酸、C反应蛋白（CRP）及血脂水平之间的相关性。方法 回顾性收集我院CCU病区2005年1月到2007年6月根据Judkins法行冠状动脉造影后有冠状动脉狭窄的286例患者（男206例，女80例）的临床资料，根据造影结果，将所有患者分为单支病变组、双支病变组、3支病变或左主干病变组3组，记录患者年龄、体重、尿酸、CRP、胆固醇、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）、甘油三酯水平，经统计学分析各组与上述危险因素的关系。结果 方差分析显示，3组间年龄、LDL-C差异有统计学意义（P〈0．05）。3组间两两分析显示，3支或左主干病变组年龄[（62±10）岁]和LDL-C[（3．0±0．7）mmol／L]水平均明显高于单支病变组[（59±11）岁、（2．8±0．6）mmol／L，均P〈0．05]。年龄、LDL-C水平与冠状动脉病变支数有相关性（r=0．163、0．149，P〈0．05）。结论 年龄、LDL-C水平越高越易发生冠状动脉狭窄，且年龄越大，LDL-C水平越高，越易发生3支或左主干病变。

Objective To study the relationship of the risk factors to the coronary artery stenosis severity in coronary atherosclerotic heart disease （CAD）. Methods 286 CAD patients, 206 males and 80 females, aged 61.6, underwent coronary angiography and then were divided into 3 groups according to its results： Group A with single vessel lesion, Group B with double vessel lesions, and Group C with triple/left main vessel lesions. Peripheral blood samples were collected to measure the levels of uric acid, C reactive protein, cholesterol, low density lipoprotein cholesterol （LDL-C）, high density lipoprotein cholesterol, and triglyceride. Spearman correlation analysis and multiple linear regression were used to analyze the relationship between the risk factors including age, bodyweight, and blood lipids and uric acid. Results There was significant difference among the three groups at age and LDL-C （ both P 〈 0.05 ）. Age and LDL-C of Group C [ （62 3±10）, （3.0 3±0. 7） mmol/L] were significantly higher than those of Group A [ （59 3±11）, （2.83±0.6） mmol/L, both P〈0.05]. Age（r=0. 163）and LDL-C（r =0. 149） were significantly associated with coronary artery stenosis severity （ both P 〈 0.05 ）. Conclusion The severity of coronary artery stenosis is affected by age and LDL-C. Triple/left main vessel lesions are likely to be seen in the patients with older age and higher blood level of LDL-C.