代谢综合征对青年女性冠心病的影响

Impact of metabolic syndrome on young female patients with coronary artery disease

目的探讨代谢综合征对年龄〈45岁的青年女性冠心病患者的发病及病变特点的影响。方法收集2005年1月至2011年12月在北京安贞医院行冠状动脉造影的20—45岁女性患者的病历资料进行回顾性分析。共302例患者入选，其中冠心病患者188例，无冠心病患者114例。对2组中代谢综合征以及其他冠心病易患因素分布进行对比研究。比较伴代谢综合征及不伴代谢综合征冠心病患者的临床特点、冠状动脉造影结果及治疗方式等。结果冠心病组代谢综合征比例明显高于非冠心病组[40．4％（76／188）比22．8％（26／114），P〈0．01]。伴代谢综合征冠心病患者急性sT段抬高心肌梗死患者的比例明显高于不伴代谢综合征者[30．2％（23／76）比17．0％（20／112），P〈0．05]。Logistic回归分析显示HDL水平[比值比（OR）为0．47，95％置信区间（凹）为0．123—0．813），P〈0．05]及入院时SBP（OR为1．018，95％CI为1．003～1．034，P=0．013）为冠心病发生的独立预测因子。结论代谢综合征是青年女性冠心病的危险因素，应早期发现，并且予以控制。

Objective To investigate the prevalence and clinical impact of metabolic syndrome （MS） on young female premature coronary heart disease（CHD）. Methods From January 2005 to December 2011, 188 CHD and 114 non-CHD young female patients （less than 45 years old） patients were included. The prevalence of MS and other coronary risk factors were compared between 2 groups. In CHD group, patients with MS and non MS were also compared for clinical features and angiographic severity. Results The percentage of MS was significant higher in young female CHD patients than that in non-CHD patients [ 40.4% （76/188 ） vs 22. 8 % （26/114）, P 〈 0.01 ]. For pa- tients with CHD combined with MS, more patients presented with ST elevated myocardial infarction [30.2% （23/76） vs 17.0% （20/112）, P 〈 0.05 ]. Multivariant regression study showed that high density lipoprotein [ odds ratio （OR） =0.47, 95% confidence interval（CI） =0. 123-0.813）, P〈0.05]and hypertension （OR =1.018, 95% CI= 1. 003-1. 034, P 〈 0.05 ） were independent predictors of CHD. Conclusions MS has a significant impact on young female CHD. HDL and hypertension are independent predictors of CHD. Young female patients with MS should be detected earlier to prevent future coronary events.