冠心病患者冠状动脉病变严重程度与冠心病危险因素的相关分析

Relationship of Coronary Stenosis Severity With its Risk Factors in Patients of Coronary Artery Disease

目的:研究冠心病患者的冠心病危险因素的特点及临床表现,探讨冠状动脉病变严重程度与冠心病危险因素相关性。方法:行冠脉造影的连续住院的患者731例。通过冠脉造影确定为冠心病者674例为冠心病组,57例冠状动脉粥样硬化患者狭窄程度<50%者为对照组。记录纳入样本的临床资料,分析心血管病危险因素,包括高敏C-反应蛋白hs-CRP水平、左心室射血分数等。分析冠心病危险因素与冠脉狭窄程度的关系。结果:冠心病组患者中男性、2型糖尿病和吸烟与冠心病相关[P均=0.00,OR(95%CI)分别为18.692(12.599～27.733)、17.533(10.421～29.500)和48.200(19.982～116.854)]。2型糖尿病,吸烟与冠脉病变严重程度相关[P均=0.00,OR(95%CI)分别为7.18(1.528～2.220)、10.09(1.998～2.527)]。冠心病患者伴随左心室射血功能减退[P=0.00,OR为1.041,95%CI(1.036～1.045)],肌酐清除率下降[P=0.00,OR为2.051,95%CI(5.137～17.594)],hs-CRP水平升高[P=0.00,OR为2.125,95%CI(1.863～2.423)],而且这些参数变化与冠脉病变严重程度相关。结论:在传统的冠心病危险因素中,吸烟、男性及2型糖尿病与冠心病患者联系更加紧密,而且心肾功能下降和hs-CRP水平升高与冠脉病变严重程度具有一定相关性。

Objective ：To explore the relationship of coronary stenosis severity with its risk factors in patients of coronary artery disease （CAD）. Methods ：A total of 731 consecutively admitted patients from July 2008 to July 2009 in our hospital were analyzed. All patients received coronary angiography and then divided into two groups. CAD group, n = 674, and Control group, n = 57, the patients with coronary stenosis 〈50%. The clinical information including classical cardiovascular disease risk factors,high sensitivity C-reactive protein （hs-CRP） creatinine clearance, left ventricle ejection fraction （LVEF） were studied to identify their relationship to CAD. Results：In CDA group, the male gender,type 2 diabetes mellitus （2-DM）and smoking were related to CAD as OR 18. 692, 95% CI（ 12. 599 - 27. 733）, OR 17. 533,95% CI（ 10. 421 - 29. 500） ,and OR 48. 200,95% CI（ 19. 982 - 116. 854）respectively, all P=0. 00.2-DM and smoking were related to coronary stenosis severity degree as OR 7.18,95% CI（ 1. 528 - 2. 220） and OR 10. 09,95% CI（ 1. 998 - 2. 527） respectively, all P = 0. 00. CAD patients had decreased LVEF as OR 1. 041,95% CI （ 1. 036 - 1. 045）, decreased creatinine clearance as OR 2. 051,95% CI （5. 137 - 17. 594 ）, and increased Hs-CRP as OR 2. 125,95 % CI （ 1. 863 - 2. 423 ）, all P = 0. 00. Those factors were associated with coronary stenosis severity degree. Conclusion ：The classical cardiovascular disease risk factors as male gender,2-DM and smoking were closely related to CAD.The impaired cardiac and renal function and elevated Hs-CRP were associated with coronary stenosis severity degree.