冠心病危险因素与冠状动脉病变的相关性分析

Correlation Between Cardiovascular Risk Factors and Characteristics of Coronary Artery Lesions

目的探讨冠心病危险因素与冠状动脉病变的相关性。方法回顾性分析我院行选择性冠状动脉造影检查(coronary angiography,CAG)337例的临床资料,设计调查表调查相关指标,依据CAG结果将其分为冠心病组和非冠心病组进行比较,分析冠心病危险因素与冠状动脉病变的关系,采用多因素Logistic回归分析筛选冠心病独立相关危险因素。结果两组血清总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、血清总胆红素(TBIL)、血尿酸(UA)、空腹血糖(FBG)、纤维蛋白原(FIB)水平比较差异有统计学意义(P<0.05或P<0.01),MPV比较差异无统计学意义(P>0.05);随着男性比例、高血压、高血脂、吸烟、糖尿病等单个危险因素及年龄、血TC、LDL-C、FBG、FIB增加,血HDL-C、TBIL降低,冠状动脉病变支数、狭窄程度逐渐增加,差异有统计学意义(P<0.05),TG、UA与冠状动脉病变支数及狭窄程度无明显关系,差异无统计学意义(P>0.05);冠状动脉病变支数、病变积分与男性比例、高血压、糖尿病、吸烟、TC、LDL-C、FBG、FIB呈正相关(r为0.114～0.248,P为0.001～0.005);与血HDL-C、TBIL呈负相关(r为-0.176和-0.182,P为0.015和0.026)。结论高血脂、高血压、吸烟、增龄、TBIL降低为冠心病的显著独立相关危险因素。

Objective To explore the correlation between cardiovascular risk factors and characteristics of coronary artery lesions in patients with coronary artery disease（CAD）.Methods 337 patients who underwent coronary angiography（CAG） in our hospital were divided into CAD group and non-coronary artery disease group according to the result of CAG and their clinical data were retrospectively analyzed.The correlation between cardiovascular risk factors and coronary artery lesions was analyzed,and the independent risk factor of CAD was screened by Multifactorial Logistic regression analysis.Results There was significant difference of TC,TG,HDL-C,LDL-C,TBIL,UA,FBG and FIB between the two groups（P0.05 or P0.01）,but no significant difference was found at the level of MPV between the two groups（P0.05）;the number of coronary artery lesion branch and the degree of stenosis were increased and HDL-C,TBIL decreased significantly when risk factors,such as male proportion,hypertension,hyperlipemia,smoking,diabetes mellitas,and other risk factors including TC,LDL-C,FBG and FIB increased,and the difference was statistically significant（P0.05）.There was no significant relation among TG,UA,the number of coronary artery lesion branch and degree of stenosis（P0.05）.The number of coronary artery lesion branch and lesion score were positively related to male proportion,hypertension,diabetes mellitas,smoking,TC,LDL-C,FBG and FIB（r： 0.114～0.248;P： 0.001～0.005）,but were negatively related to HDL-C,TBIL（r：-0.176,-0.182;P：0.014,0.026）.Conclusion The results suggest that the hyperlipidemia,hypertension,smoking,aging and lower TBIL are the prominent predictors of CAD.