主动脉瓣钙化危险因素分析及其与冠心病关系的探讨

Analysis on risk factors of aortic valve calcification and its correlation with coronary heart disease

目的探讨主动脉瓣钙化的相关危险因素及其与冠状动脉（冠脉）病变程度的关系。方法2010年4月至2011年4月在天津医科大学第二医院行冠脉造影和超声心动图检查患者188例，将其分为主动脉瓣钙化组（AVC）101例和非主动脉瓣钙化组（NAVC）87例，记录性别、年龄、身高、体质量和高血压、糖尿病、吸烟史等一般情况，血糖、血脂、同型半胱氨酸水平等相关化验结果，并对上述指标和主动脉钙化间的关系进行分析。结果AVC组和NAVc组比较，年龄分别为（67．0±9．0）岁和（59．4±6．9）岁（t=6．74，P=0．000）、男性36例（35．6％）和44例（50．6％）（Х^2=4．26，P=0．039）、高血压72例（71．3％）和50例（57．5％）（Х^=3．92，P=0．048）、胆固醇（5．4±1．0）mmol／L和（4．5±1．0）mmol／L（t=5．70，P=0．000）、三酰甘油（2．2±1．1）mmol／I。和（1．6±0．8）mmol／L（t=4．04，P=0．000）、同型半胱氨酸（17．6±8．8）μmol／L和（14．9±6．6）μmol／L（t=2．86，P=0．028）。单因素分析结果显示，年龄、性别、高血压、胆固醇、三酰甘油与主动脉钙化具有相关性；按是否患冠心病进行分组后，同型半胱氨酸水平差异无统计学意义（t=0．88，P=0．382）。进一步Logistic逐步回归，年龄、胆固醇、三酰甘油、同型半胱氨酸水平均为主动脉瓣钙化的独立危险因素，心脏瓣膜钙化与冠脉病变程度相关（Х^2=9．48，P=0．024）。结论主动脉瓣钙化的独立危险因素为年龄、胆固醇、三酰甘油、同型半胱氨酸水平；冠脉病变程度重者主动脉瓣钙化发生率高。

Objective To analyze the risk factors of aortic valve calcification, and discuss its correlation with coronary artery disease. Methods A total of 188 patients who underwent coronary angiography （CAG） and transthoracic echocardiography （TTE） were divided into two groups： 101 cases with aortic valve calcification （AVC） and 87 cases without AVC （NAVC）. General data such as sex,age, height, weight and hypertension history, results of blood test such as glucose, lipid and homocysteine（HCY）level were recorded. Results In AVC versus NAVC group, age were （67.0± 9.0）years vs. （59.4±6.9） years （t=6.74,P=0.000）, men were 36 cases （35.6%） vs. 44 cases （50.6%） （t=4.26,P=0. 039）, hypertension patients were 72 cases （71.3%） vs. 50 cases （57.5%） （X^2 =3.92,P= 0. 048）, total cholesterol were （5.4 ± 1.0） mmol/L vs. （4.5 ± 1.0） mmol/L （t = 5.70,P=0.000）, triglyceride were （2.2±1.1） mmol/L vs. （1.6±0.8）mmol/L （t=4.04,P= 0.000）, HCY were （17.6 ± 8.8） μmol/L vs. （14.9 ± 6.6） μmol/L （t = 2.86, P= 0.028）, respectively. One-way analysis showed that age, sex, hypertension, total cholesterol, triglyceride had relationship with aortic valve calcification. When we divided the cases into two groups （with and without coronary disease）,there is no significant difference in HCY（t= 0.88 ,P=0. 382） between the two groups. Logistic regression indicated that age, total cholesterol, triglycerides, HCY were independent risk factors of aortic valve calcification, the incidence of aortic valve calcification was related with the severity of coronary artery lesion （Xz = 9.48, P = 0. 024）. Conclusions The independent risk factors of aortic valve calcification are age, cholesterol, triglyceride, HCY. Higher incidence of aortic valve calcification may result in greater severity coronary artery lesion.