冠状动脉斑块程度与冠心病危险因素的相关性分析

Analysis of Correlation between the Degree of Coronary Plaque and Risk Factors of Coronary Heart Disease

目的分析冠状动脉斑块程度与冠心病危险因素的相关性。方法将2013年2月至2014年8月在济宁医学院附属医院进行冠状动脉CT检查的688例资料完整的患者按照斑块严重程度分为正常组(228例)、轻度斑块组(113例)、中度斑块组(101例)、重度斑块组(78例)、再血管化组(115例)。对患者血生化参数、颈动脉及心脏超声结果进行分析。结果轻度斑块组高密度脂蛋白胆固醇、校正肾小球过滤率显著低于正常组,Framingham评分显著高于正常组(P<0.05)。中度斑块组高密度脂蛋白胆固醇、校正肾小球过滤显著低于轻度斑块组和正常组,校正肾小球过滤率、颈动脉内膜厚度、Framingham评分显著高于轻度斑块组和正常组,同型半胱氨酸、低密度脂蛋白胆固醇显著高于正常组(P<0.05)。重度斑块组高密度脂蛋白显著低于中度斑块组、轻度斑块组和正常组,校正肾小球过滤率显著低于轻度斑块组和正常组,总胆固醇显著高于正常组,同型半胱氨酸、Framingham评分、颈动脉内膜厚度、低密度脂蛋白胆固醇显著高于轻度斑块组和正常组(P<0.05)。再血化管组高密度脂蛋白胆固醇显著低于重度斑块组、中度斑块组、轻度斑块组、正常组,校正肾小球过滤显著低于轻度斑块组、正常组,同型半胱氨酸、Framingham评分显著高于中度斑块组、轻度斑块组、正常组,颈动脉内膜厚度、低密度脂蛋白显著高于重度斑块组、中度斑块组、轻度斑块组、正常组,总胆固醇显著高于轻度斑块组、正常组(P<0.05)。高血压、心脏病、高密度脂蛋白、同型半胱氨酸、Framingham评分、颈动脉内膜厚度、总胆固醇、低密度脂蛋白为影响动脉粥样硬化斑块程度的危险因素。结论肌酐、Framingham积分、颈动脉内膜厚度、同型半胱氨酸等冠心病危险因素,与冠状动脉狭窄程度具有一定的关联性。

Objective To analyze correlation of the degree of coronary plaque risk factors of coronary heart disease. Methods From Feb. 2013 to Aug. 2014 in Jining Medical College Hospital for coronary magi- ography of 688 cases of patients with complete data research grant. According to the plaque severity divided all patients into normal group （ 228 cases）, mild plaque group （ 113 cases）, moderate group （ 101 cases ）, severe plaque group（78 cases） and vascularization group（ 115 cases）. Different levels of plaque in patients such as triglycerides, urea, urine protein, uric acid, fasting glucose, glycated hemoglobin, hemoglobin, tropo- nin, left ventricular end-diastolic Neijing, left ventricular ejection fraction with clinical data and blood bio- chemical parameters the results of carotid artery and heart ultrasound were analyzed. Results The high den- sity lipoprotein cholesterol, correction glomerular filtration of mild plaque group were significantly lower than normal group, correction glomerular filtration, high density lipoprotein cholesterol of moderate plaque group significantly lower than mild plaque group and normal group framingham grade were significantly higher than normal group （ P 〈 0.05 ）. Homocysteine, low density lipoprotein cholesterol of severe plaque group was sig- nificantly higher than normal group, correction of glomendar filtration, carotic artery intima-media thickness, Framingham grade of severe plaque group were significanly higher than mild plaque group and normal group, high density lipoprotein cholesterol of severe plaque group significantly lower than moderate plaque group, mild plaque group and normal group, correction of glomerular filtration ＂significantly lower than mild plaque group and normal group, total cholesterol significantly higher than normal group, homocysteine, Framingham grade,carotid intima thickness,low density lipoprotein cholesterol of of severe plaque group significantly higher than mild plaque group and normal group （P 〈 0. 05 ）. High density lipoprotein cholesterol of vascular- ization group were significantly lower than moderate group, mild plaque group, normal group, correction of glo- merular filtration significantly lower than mild plaque group and normal group, homocysteine, Framingham grade significantly of vascularization group were higher than moderate group and mild plaque group, normal group （P 〈 0.05 ）. Carotid artery intima thiCkness,low density lipoprotein cholesterol significantly higher than severe plaque group, moderate group, mild plaque group, normal group, total cholesterol significantly higher than mild plaque group, normal group（P 〈 0.05 ）. Hypertension, heart disease rates gradually increased pro- portion. High-density lipoprotein, homocysteine, Framingham score, carotid IMT, total cholesterol,low-density lipoprotein were independent risk factor for atherosclerotic plaque extent. Conclusion Coronary plaque has some relevance in creatinine, Framingham score, carotid artery intima-media thickness, homocysteine and other coronary risk factors.