≤45岁早发冠心病患者危险因素分析

ANALYSE OF RISK FACTORS IN PATIENTS WITH CORONARY HEART DISEASE BELOW THE AGE OF 45 YEARS

[目的]研究≤45岁早发冠心病(CHD)人群的危险因素特点。[方法]研究对象为2004年01月～2006年12月住院行冠状动脉造影检查者,年龄均≤45岁,共计189例。按冠脉造影结果进行分组,其中126例冠状动脉管腔狭窄≥50%者定为CHD组,63例冠状动脉管腔狭窄﹤50%者确定为对照组。全部研究对象均进行详细病史采集和相应血生化指标测定.从外周血白细胞中抽提脱氧核糖核苷酸(DNA),采用酚/氯仿方法;传统多聚酶链反应(PCR)加内切酶技术检测纤维蛋白原βHae111多态性。血浆纤维蛋白原测定采用凝血酶方法。血清总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)及高密度脂蛋白胆固醇(HDL-C)测定采用标准酶法。高血压、糖尿病入选标准:①既往有明确高血压病、糖尿病诊断者;②本次入院确诊者。每日吸烟一支以上超过一年定为吸烟者。所有数据采用SPSS11.0统计软件进行统计分析,危险因素分析采用t检验和χ2检验,P﹤0.05认为差异有统计学意义。[结果]两组年龄、性别、TC、TG、LDL-C和血浆纤维蛋白原水平均无统计学差异;吸烟、高血压、糖尿病、血清HDL-C浓度以及纤维蛋白原βHae111多态性分布两组间均显示明显不同。[结论]≤45岁CHD人群危险因素分布特点以吸烟、高血压、糖尿病者居多,HDL-C保护机制降低,并明显受纤维蛋白原基因βHae111多态性的影响。

[ Objective] To study the risk factors of early onset （below 45 year old） coronary heart disease （CHD） . [Methods] 189 patients under45-year-old with coronary arteriography in hospital from September, 2003 to December, 2005 were included. The patients were divided into two groups： 126 patients with coronary artery lumens＇ stenosis over 50% were in CHD group, and the other 63 ones were in control group. All patients had medical history recorded and blood biochemical indicator determined. Genomie DNA was isolated from the patients＇ white blood cells in phenol/chloroform method. Fibrinogen bHae111 gene polymorphism was detected by polymerase chain reaction （PCR） and incision enzyme. Plasma fibrinogen was determined in thrombin method, and serum total cholesterol （TC）, triglyceride （TG）, low density lipoprotein cholesterol （LDL- C）, high density lipopretein cholesterol （HDL-C） were determined in standard enzymic method. Patients with hypertension and/or diabetes had been finally diagnosed. The smoker was defined as smoking over one cigarette/day for more than one year. SPSS11.0 software was used for statistical analyses, t test and χ^2 test were used for risk factor analyses. P 〈 0.05 was considered significant deviation statistically. [ Results] There was no significant difference between the two groups in mean age, distribution of gender, TC, TG, LDL-C and levels of plasma fibrinogen. However, the factors such as smoking, hypertension, diabetes, serum HDL-C concentration and fibrinogen bHae111 gene polymorphism were remarkably different, as listed in the table. [ Conclusion] Smoking, hypertension, diabetes, lower concentration of serum HDL-C and fibrinogen bHae111 gene polymorphism are the risk factors of early onset CHD.