代谢综合征对高血压患者冠脉病变的影响

Influence of metabolic syndrome on coronary artery disease in patients with hypertension

目的:探讨代谢综合征(MS)对高血压患者冠脉病变的影响。方法:选择高血压病患者220例为研究对象。根据是否合并MS,患者被分为MS组(90例)和单纯高血压组(对照组,130例)。采用冠脉造影检测冠脉病变血管分布及病变支数,行Gensini评分,对两组冠脉病变程度进行分析比较。结果:MS组的冠心病检出率显著高于对照组(84.44%比71.54%),χ2=4.974,P=0.026。与对照组比较,MS组患者左回旋支(29.23%比44.44%)及右冠状动脉病变比例(23.08%比38.89%)显著升高,P均<0.05。MS组Gensini评分显著高于对照组[(40.71±25.79)分比(32.69±20.64)分,P=0.011],且MS组3支病变比例显著高于对照组(40.00%比26.15%),χ2=4.700,P=0.03。结论:代谢综合征显著增加高血压患者冠状动脉病变的严重程度。

Objective： To explore the influence of metabolic syndrome （MS） on coronary artery disease in patients with hypertension. Methods.. A total of 220 patients with hypertension were enrolled. According to complicated with MS or not, they were divided into MS group （n = 90） and pure hypertension group （control group, n = 130）. Coronary angiography was used to measure distribution and number of diseased coronary vessels, Gensini scoring wasalso performed to compare and analyze severity of coronary disease between two groups. Results： Detection rate of CHD in MS group was significantly higher than that of control group （84. 44% vs. 71.54%）, ;（z = 4. 974, P = 0. 026. Compared with control group, there were significant rise in percentages of left circumflex coronary artery （29.23% vs. 44.44%） and right coronary artery lesions （23.08% vs. 38. 89%）, P〈0.05 both; significant rise in Gensini score [ （32.69 ± 20.64） scores vs. （40.71 ± 25.79） scores, P = 0. 011] and percentage of three - vessel coro- nary artery disease （26.15% vs. 40.00%, X2=4. 700, P = 0.03） in MS group. Conclusion： Metabolic syndrome significantly elevates severity of coronary artery disease in patients with hypertension.