冠心病患者合并代谢综合征危险因素与冠状动脉病变的关系

Relationship between multiple risk factors and coronary artery lesions in the patients with coronary heart disease and metabolic syndrome

目的探讨冠心病(congenital heart disease,CHD)合并代谢综合征(metabolic syndrome,MS)患者与冠状动脉病变(coronary atherosclerotic heart disease,CAD)严重程度的关系。方法入选经冠动脉造影确诊冠心病429例。按冠心病是否合并代谢综合征进行分组。所有患者均查体质指数(BMI)、血压(BP)、空腹血糖(FBG)、甘油三酯(TG)、高密度脂蛋白(HDL-c)、总胆固醇(TC)、低密度脂蛋白(LDL-c)、血尿酸(UA)及年龄、性别、吸烟等。结果合并代谢综合征组的BMI、BP、FBG、TG、HDL-c、TC、LDL-c、UA均显著高于与单纯冠心病组(P<0.05),冠状动脉病变Gensini评分和病变支数明显增加(P<0.01);HDL-c、LDL-c、BMI与冠状动脉病变程度显著相关(P<0.01)。结论冠心病患者合并代谢综合征可加重冠状动脉病变严重程度,HDL-c、LDL-c、BMI可作为预测冠状动脉狭窄严重程度的参考指标之一。

Objective To investigate factors in the patients with metabolic syndrome relationship between coronary artery lesions and multiple risk （MS） and coronary heart disease （CHD）. Methods Totally 429 patients were definitely diagnosed with CHD by coronary arteriography and their BMI, BP, FBG, TG, HDL-c as well as age, gender, smoking, TC, LDL-c, UA were recorded. All patients were divided into two groups： CHD with MS, CHD. Results BMI, BP, FBG, TG, HDL-c, TC, LDL-c and UA were significantly higher in CHD with MS group than those in CHD group （ P 〈 0.05 ）. The Gensini scores got higher and the affected vessels increased in number （P 〈 0.01 ） in both the two groups. Arterial stenosis was more severe in the CHD with MS group （ P 〈 0.01 ）. The coronary artery lesions were significantly correlated with HDL-c, LDL-c and BMI （P 〈0.01）. Conclusion CHD complicated with MS aggravates coronary artery lesions. HDL-c, LDL-c and BMI can serve as the predictors of CHD severity.