冠心病患者血清镁离子浓度与冠状动脉狭窄程度研究

Relationship between serum magnesium and the severity of coronary artery disease

目的 分析冠心病患者血清镁离子浓度与冠状动脉狭窄程度的关系。方法 所有研究对象均来自2008年10月至2011年12月在广州市3家医院纳入的广东冠心病队列。采用横断面调查方法收集病例的人口学特征、吸烟、饮酒、体育运动、本次入院情况等基本情况,并收集入院第2天清晨空腹血液标本用于血常规、血生化及实验室检测血清镁离子浓度和C反应蛋白（CRP）。对血清镁离子水平及其他相关因素与冠心病患者冠脉造影狭窄程度是否〉75%的关系进行单因素和多因素logistic回归分析。结果 广东冠心病队列共1 980例患者,本次研究纳入979例冠心病患者,纳入病例、总队列病例平均年龄分别为（62.62±11.03）、（63.63±11.84）岁;BMI分别为（23.87±3.36）、（23.88±3.33）;男性占的比例分别为73.24%、65.60%,两者比较除BMI的差异无统计学意义外,平均年龄和性别构成的差异均有统计学意义（均P〈0.01）。单因素logistic回归分析结果显示,在男性中不同血清镁离子浓度组冠脉造影狭窄程度〉75%的危险度差异有统计学意义,而女性差异未见统计学意义。多因素logistic回归分析结果显示,对年龄、BMI、收缩压、吸烟、饮酒、体育运动等因素进行校正后,男性中血清镁离子浓度为0.39~0.84、0.92~0.99、〉0.99 mmol/L的病例冠脉造影狭窄程度〉75%的危险度分别是参考组（0.85~0.91 mmol/L）的1.93、1.77、2.14倍。结论 在被调查男性冠心病患者中血清镁离子浓度与冠状动脉狭窄程度的关系并非线性关系,将血清镁离子浓度控制在中等程度更有利于预防冠状动脉严重狭窄。

Objective To study the relationship between magnesium level in serum of patients with coronary heart disease and the extent of coronary artery stenosis. Methods Patients were selected from Guangzhou Coronary Artery Disease Cohort in 3 hospitals in Guangzhou from October 2008 to Decem- ber 2011. Patients＇ characteristics of smoking, alcohol consumption, physical activity and admission condi- tion were collected by cross-sectional method. Their fasting blood specimens in the second day morning af- ter admission were taken for test of blood routine, serum magnesium, and C-active protein （CRP）. Univa- riate and multivariate logistic regressions were used to analyze the data. Results There were 1 980 pa- tients in the Guangzhou Coronary Artery Disease Cohort, and 979 subjects were included in the final analy- sis. The average age was （63.63 ± 11.84） years for the total patient cohort and （62.62 ± 11.03 ） for the subjects included （ P 〈 0.01 ）, the average BMI was （23.88± 3.33 ） for the cohort and （ 23.87 ± 3.36） for the subjects （P 〉0. 05）, and proportion of the males was 65.60% for the cohort and 73.24% for the subjects （P 〈 0.01 ）. In the univariate logistic regression, the relationship between different serum magne-sium level and coronary artery stenosis 〉75% had statistically significant in male, but not in female. After adjusted for age, BMI, systolic blood pressure, smoking, alcohol consumption, physical activity in the multivariate logistic regression, the serum magnesium levels at 0.39 - 0.84, 0.92 - 0.99 and 〉 0.99 mmol/L had significant risk for coronary artery stenosis 〉 75% compared with those at 0. 85 - 0. 91 mmol/L in males （OR： 1.93, 1.77, 2.14, respectively）. Conclusion Serum magnesium level and coro- nary artery stenosis in male patients were not a simple liner relationship. It might be conducive to the pre- vention of coronary heart disease to keep serum magnesium at moderate level.