冠心病危险因素与冠状动脉病变特点的临床分析

Clinical Analysis of Risk Factors for Coronary Heart Disease and Characteristics of Coronary Artery Lesions

目的探讨冠心病患者冠状动脉病变特点与相关危险因素的关系。方法选择2008-01/2009-07月作者医院收治的因诊断或疑诊为冠心病而行冠状动脉造影的430例住院患者,依据冠状动脉造影显示的冠状动脉病变情况分为冠心病组(282例)和对照组(148例),回顾性分析患者既往是否合并有吸烟、高血压、高脂血症、糖尿病等冠心病危险因素,并与冠状动脉病变的关系进行多元回归分析。结果冠心病组患者的收缩压和脉压差水平、超敏C反应蛋白、血浆纤维蛋白原和糖化血红蛋白水平较对照组均明显升高(P<0.01);性别、年龄、血浆纤维蛋白原、高甘油三脂血症和糖尿病史是冠心病的独立危险因素(P<0.05),且与冠状动脉病变范围和积分密切相关。结论冠心病患者以男性多发,合并有吸烟史、糖尿病史,血清超敏C反应蛋白、血浆纤维蛋白原高水平及高甘油三脂血症的患者是冠心病的高危人群。

Objective To investigate the relationship between the risk factors for coronary heart disease and characteristics of coronary artery lesions.Methods Four hundred and thirty patients diagnosed or suspected as coronary artery heart disease （CHD） in our hospital between January 2008 and July 2009,were divided into coronary heart disease group （CHD group,n=282） and non-coronary heart disease group （control group,n=148） according to the coronary angiography （CAG）.The symptoms,signs,laboratory data,CAG and interventional therapy were recorded.The risk factors,including smoking,hypertension,hyperlipemia and diabetes mellitus （DM） of the patients were retrospectively analysed.Multiple regression analysis was used to study the relationship between CHD and these factors.Results The CHD group had higher level of systolic pressure,pulse pressure,hs-CRP,plasma fibrinogen and HbA1c than the control group （P0.01）.Sex,age,hypertriglyceridemia,DM and high level of plasma fibrinogen were independent risk factors for CHD.Conclusion Male,smoker,and the patients with DM,hypertriglyceridemia,and high level of hs-CRP or plasma fibrinogen,are high risk population for CHD.