女性冠心病患者危险因素与冠状动脉病变程度的相关性分析

Correlation between cardiovascular risk factors and the severity of coronary artery lesions in female patients

目的探讨冠心病传统危险因素及新危险因素与女性冠心病患者的冠脉病变严重程度的关系。方法疑似女性冠心病患者行冠脉造影住院患者235例,经冠脉造影确诊女性冠心病患者156例,女性非冠心病患者76例。采用单因素和多因素分析冠心病危险因素和冠脉病变程度。结果(1)在不同程度冠脉病变组间比较,单因素分析显示随冠脉造影病变支数或病变Gensini总积分增加,各组中危险因素(高血压病、2型糖尿病、高甘油三酯、高总胆固醇、低高密度脂蛋白胆固醇、高低密度脂蛋白胆固醇、高尿酸病、高纤维蛋白原)的百分率也随之增加。(2)多因素回归分析显示:高低高密度脂蛋白胆固醇(LDL-C)水平为诊断冠心病最显著的独立相关危险因素,其他危险因素依次为糖尿病、甘油三酯、高尿酸、低高密度脂蛋白胆固醇、高血压、年龄。结论女性冠心病人中存在多个危险因素,其中高低高密度脂蛋白胆固醇是女性冠心病最显著的独立相关危险因素,但新的危险因素尿酸值得重视。

Objective To investigate the association of the traditional and newly emerged cardiovascular risk factors with the severity of coronary artery lesion in female patients with coronary artery disease （CAD）. Methods This study involved 235 female in-patients undergoing coronary angiography, including 156 with confirmed coronary artery disease （CAD） and 76 non-CAD patients. Univariate and multivariate analysis of the cardiovascular risk factors and the severity of coronary artery lesion were carried out in these patients. Results Univariate analysis showed that in the CAD patients of different severities, increased number of compromised arteries and total Gensini scores for the lesions were associated with increased incidences of the such risk factors including hypertension, type 2 diabetes, high triglycerides, high total cholesterol, low high-density lipoprotein cholesterol （HDL-C）level, high low density lipoprotein cholesterol （LDL-C） level, high uric acid level and high fibrinogen level. Multivariate regression analysis showed that high LDL-C level was the most significant independent risk factor for CAD, followed by diabetes, triglycerides, high uric acid, low HDL-C, high blood pressure and age. Conclusion Female CAD patients are exposed to multiple risk factors, among which high LDL-C level is the most significant independent risk factor, but the other risk factors, especially the newly emerged factor uric acid, should be given due attention in the patients.