早发冠心病患者冠状动脉病变特点及危险因素的临床研究

Clinical study on the risk factors and coronary features of patients with premature coronary heart disease

目的探讨早发冠心病患者的冠状动脉病变特点及相关危险因素。方法152例经冠状动脉造影确诊的冠心病患者,根据年龄分为早发冠心病组(男性<55岁,女性<65岁)74例和老年冠心病组78例。对两组患者的相关资料进行回顾性统计分析,比较二者的冠状动脉病变特点、血脂水平、高血压病史、糖尿病病史、冠心病家族史、吸烟史、饮酒史等,评价其是否存在差异性。结果早发冠心病组中吸烟史,冠心病家族史,血清总胆固醇高于老年冠心病组;而高血压病史、糖尿病史低于老年冠心病组。早发冠心病组冠状动脉病变多为单支病变,老年冠心病组以多支病变为主。结论吸烟、冠心病阳性家族史,高胆固醇血症均是早发冠心病的主要危险因素。冠状动脉病变特点以单支病变为主。

Objective To investigate the risk factors and clinical manifestation of coronary lesions in Patients with premature coronary heart disease. Methods Coronary angiography was done in 152 coronary heart disease （CHD） patients were derided into two groups by age. 74 patients with premature CHD （male〈55 years-old, female〈65 years-old） were compared with 78 patients with gerontism CHD. To illustrate the risk factors of premature CHD and the clinical features of coronary lesions. Results The percentage of smoking and family history of CHD were higher in patients with premature CHD than those in patients with gerontism CHD. But the patients with premature CHD had lower rate of hypertension and diabetes compared with the patients with gerontism CHD.Patients with premature CHD had higher levels of serum total cholesterol （TCH） and low-density lipoprotein cholesterol （LDL-C） compared with the patients with gerontism CHD. The difference was significant. Coronary arteriongraphy showed that single-vessel lesions appeared more in patients with premature CHD, multi-vessel lesions appeared more in patients with gerontism CHD. Conclusion Smoking,family history of CHD,hypereholesterolemia are important risk factors for patients with premature CHD. Most of the patients with premature CHD are singlevessel lesions. CHD preventing should begin with controlling the CHD risk factors.