青年冠心病患者危险因素与冠状动脉病变程度的关系

RELATIONSHIPS BETWEEN THE RISK FACTORS IN PATIENTS WITH CORONARY ARTERY DISEASE UNDER 40 YEARS OLD AND THE SEVERITY OF CORONARY ARTERY LESIONS

目的 :探讨国人 40岁以下冠心病患者危险因素与其冠状动脉 (冠脉 )病变程度之间的关系。方法 :根据冠状动脉造影结果将 10 8例 40岁以下 (含 40岁 )行冠脉造影者分为冠心病组 (6 2例 )和非冠心病组 (4 6例 ) ,进行危险因素调查并加以分析。结果 :男性患者多支病变多于女性 (5 8%vs 2 9% ,P <0 .0 5 ) ,冠脉病变积分高于女性 (12 .84± 5 .47vs 17.5 3± 3.16 ,P <0 .0 5 ) ,Logistic回归分析显著冠心病家族史、血浆总胆固醇水平及男性性别为冠心病的独立危险因素 ,其比值比 (OR)分别为 3.99(95 %CI 1.39～ 11.5 2 ) ,2 .0 9(95CI 1.30～3.48)和 2 .15 (95 %CI 1.16～ 3.86 ) (P =0 .0 11～ 0 .0 0 4) ;冠脉病变积分与冠心病家族史、血总胆固醇水平及男性性别呈正相关 ,r分别为 0 .36 7,0 .416和 0 .391,P均 <0 .0 5。结论 :冠心病家族史、血浆总胆固醇水平及男性性别对青年人冠心病的发生、发展有着重要促进作用。

Objective:To determine the risk factors in patients with coronary artery disease (CAD) under 40 years old and their relationships with severity of coronary artery lesions. Methods:One hundred and eight adults under 40 years old who had undergone coronary angiography were divided into 2 groups:Group Ⅰ(n=62) with evidence of angiographic CAD and Group Ⅱ (n=46) with non-CAD as control. The CAD risk factors were also studied. Results:Male patients had a higher incidence of multivessel disease(58% vs 29%, P <0.05) and a higher severity score (12.84±5.47 vs 17.53±3.16, P <0.05).Through Logistic regression analysis, family history of CAD and total blood cholesterol level and male gender were confirmed to be independent risk factors for CAD, and the odd ratios (OR) were 3.99(95%CI 1.39～11.52),2.09(95CI 1.30～3.48) and 2.15(95%CI 1.16～3.86) respectively.( P =0.011～0.004). A positive correlation ( r =0.367～0.416, P <0.05) was found between angiographic score and the risk factors concerned above. Conclusions:Coronary artery lesions is affected by the risk factors of family history and total blood cholesterol level and male gender in young adults.