不同年龄阶段冠心病患者危险因素的对比分析

Risk factors in patients with coronary artery disease in different ages

目的:探讨不同年龄阶段冠心病患者危险因素的差别以及血清氧化低密度脂蛋白(Ox-LDL)在中青年冠心病患者中的相关性是否与老年患者存在差异。方法:入选冠心病患者178例,对照组患者169例,各再分别按照年龄分为A组:≤55岁;B组:56～70岁;C组:≥71岁。采用ELISA法测定血清Ox-LDL,分析不同年龄阶段冠心病患者的危险因素及Ox-LDL的差异。结果:在A组患者中,男性、吸烟、高甘油三酯血症、Ox-LDL、超敏C反应蛋白(hs-CRP)是冠心病的独立危险因素(P<0.05)。在B、C组患者中,吸烟、高血压病、糖尿病、总胆固醇、低密度脂蛋白、Ox-LDL、hs-CRP是冠心病的独立危险因素(P<0.05)。在不同年龄阶段患者中,校正了性别、年龄、血脂异常、吸烟、高血压病、糖尿病、hs-CRP等因素后,Ox-LDL均为冠心病的独立危险因素,但在A组患者中相关性更为明显。结论:不同年龄阶段冠心病患者的危险因素存在一定差别。Ox-LDL是冠心病的独立危险因素,但在中青年患者中其相关性更为明显,提示体内氧化应激是早发冠心病的重要危险因素。

Objective To study the risk factors in patients with coronary artery disease （CAD） in different ages and the risk effect of oxidized low-density lipoprotein （Ox-LDL） in young, middle-aged, and old patients with CAD. Methods 178 CAD patients were enrolled, and 169 non-CAD individuals were set as control group. All the patients were grouped into A： age≤55 years; B： 56-70 years, C： ≥71 years. Conventional risk factors were evaluated. Ox-LDL was measured by ELISA. The risk factors and the risk effect of Ox-LDL in different groups were analyzed. Results In group A, male sex, smoking, lipid abnormality, ox-LDL and hs-CRP were independent risk factors for CAD （P 〈 0.05）. While in group B and C, smoking, hypertension, diabetes mellitus, total cholesterol, low-density lipoprotein cholesterol, Ox-LDL and hs-CRP were independent risk factors for CAD （P 〈 0.05）. Ox-LDL was the independent risk factor for CAD in all age groups after adjusted for sex, age, hypertension, and hs-CRP. However, it is more significant in group A. Conclusions The risk factors in patients with CAD in different ages were different. Ox-LDL is an important independent risk factor for CAD, especially in young and middle age. It suggest oxidative stress may play an important role in premature CAD.