代谢综合征组分的聚集加重了冠状动脉狭窄程度和左心室肥厚

Aggregations of metabolic syndrome (MS) components aggravate the severity of coronary artery stenosis and left ventricular hypertrophy

目的从冠状血管造影和超声心动图的角度探讨不同特征代谢综合征（MS）组分的聚集与冠状动脉病变程度和左心室肥厚（LVH）的关系。方法2000年至2004年间入院并进行冠状动脉造影的患者492例,根据MS定义中代谢异常组分的累加评分（0-4分）分为5组。比较各组间冠心病（CHD）发生比例、严重程度及左心室质量等差异。结果随着代谢异常的增加,左前降支血管狭窄百分数,狭窄血管数目,冠脉狭窄积分及CHD比例均随之增加（P值分别为0.002,0.008,0.007,0.042）;室间隔厚度、左心室后壁厚度和左心室质量也随之增加（P值分别为0.016,0.02,0.03）。Logistic回归分析结果显示,代谢异常评分每增加1分,发生CHD的相对危险度增加1.29倍（95%CI：1.09-1.53）。结论MS患者更易发生冠状动脉狭窄和LVH,且随着代谢异常的累积,冠脉狭窄程度、受累血管数目和左心室质量也有所增加。

Objective To examine the effect of aggregations of MS components on angiographic coronary artery disease severity and echocardlographic left ventricular hypertrophy. Methods We evaluated 492 hospitalized patients aged 29-88 years in Huashan Hospital in 2000-2004 who underwent elective coronary angiography. Patients were categorized into 0 to 5 groups according to component number of metabolic syndrome, The severity of lesion, sum of lesion vessels, rate of coronary artery disease and left ventricular mass （left ventricular mass index） were compared among groups. Results As the metabolic disorder score increased, so did the parameters of stenosis percentages of three main coronary arteries, the number of lesion vessels, and coronary stenosis score （P value was 0. 002, 0. 268, 0. 136, 0. 008, 0. 007, respectively）. As the score increased, so did the interventricular septal thickness, posterior wall thickness, left ventricular mass and left ventricular mass index （P value was 0. 016, 0. 02, 0. 03, and 0. 021, respectively）. When metabolic disoirder score increased by 1 point, the relative risk of the coronary artery disease prevalence elevated by 1.29 （95 %CI：1. 09-1.53）. Conclusions The degree of metabolic disorder clustering is strongly related to the severity of coronary artery disease and left ventricular hypertrophy.