中青年冠状动脉粥样硬化危险因素分析

Evaluation of coronary artery with 64-slice coronary computed tomography angioplasty and analysis of the risk factors in young and middle-aged health checkup receivers

目的探讨中青年健康体检者冠状动脉CT成像特点及与常见心血管病危险因素的关系。方法 2011-03至2011-06在我院健康医学中心行64层冠脉CT(computed tomographic angiography,CTA)检查的60岁以下成人186例,根据CTA结果将健康体检者分为冠状动脉正常组、冠状动脉粥样硬化组。对常见危险因素进行单因素分析及多元Logistic回归分析。结果单因素分析发现,冠状动脉粥样硬化受性别(χ2=22.85,P=0.00)、吸烟(χ2=4.24,P=0.04)、高血压(χ2=5.85,P=O.02)、糖尿病(χ2=5.96,P=0.02)影响;多元回归分析结果表明,性别(χ2=14.77,P=0.00)、低密度脂蛋白胆固醇(χ2=10.43,P=0.00)、吸烟(χ2=6.38,P=0.01)、年龄(χ2=4.93,P=0.03)、总胆固醇(χ2=4.16,P=O.04)与冠状动脉粥样硬化呈正相关。结论本研究认为,冠脉CTA成像可作为中青年健康体检者冠心病的常规筛查手段;在中青年健康体检者中,吸烟、总胆固醇、低密度脂蛋白胆固醇、性别和年龄与冠状动脉粥样硬化密切相关。

Objective To identify the characteristics of coronary artery in young and middle-aged health checkup receivers using 64-slice coronary computed tomography angioplasty（CTA） and to investigate the relation with common risk factors for coronary stenosis.Methods From March 2011 to June 2011,186 young and middle-aged health checkup subjects underwent the examination of coronary CTA.According to the results of CTA,the subjects were divided into two groups according to the degree of coronary stenosis.The data were analyzed by Chi square test and multiple regression logistic analysis.Results Chi square test showed that coronary atherosclerosis was subjected to influence by gender（χ2=22.85,P=0.00）,smoking（χ2=4.24,P=0.04）,hypertension（χ2=5.85,P=0.02）,and diabetes mellitus（DM）（χ2=5.96,P=0.02）.Multiple logistic regression analysis showed that gender（χ2=14.77,P=0.00）,LDL-C（χ2=10.43,P=0.00）,smoking（χ2=6.38,P=0.01）,age（χ2=4.93,P=0.03）,and total cholesterol（TC）（χ2=4.16,P=0.04） were closely correlated with coronary atherosclerosis.Conclusions Cardiac CTA can be used as a routine imaging screening tool for young and middle-aged health checkup subjects.Gender,smoking,age,TC and LDL-C show clinically close correlation with the degree of coronary stenosis among young and middle-aged health checkup receviers.