老龄冠状动脉粥样硬化性心脏病患者冠状动脉钙化危险因素分析

Risk factors for coronary artery calcification in patients with coronary artery diseases

目的：分析老龄冠心病患者发生冠状动脉钙化的临床危险因素。方法：分析165例老年冠心病患者的心血管危险因素、生化数据。多排螺旋计算机体层扫描（MDCT）冠状动脉成像评估患者冠状动脉钙化情况,Agatston法计算钙化积分,多因素Logistic回归分析老龄冠心病伴冠状动脉钙化患者的危险因素。结果：钙化组患者收缩压水平、血肌酐及血尿酸水平、糖尿病发生率及吸烟率均高于非钙化组,差异有统计学意义（P〈0.023-0.035）,多因素Logistic回归分析显示,年龄（OR=1.032,P=0.035）、收缩压（OR=1.546,P=0.024）、吸烟史（OR=1.328,P=0.029）、血肌酐增高（OR=1.325,P=0.025）、糖化血红蛋白（OR=1.697,P=0.031）、血尿酸水平（OR=1.732,P=0.015）为冠状动脉钙化性斑块形成的危险因素,Spearman分析显示糖化血红蛋白、血肌酐和尿酸水平与钙化积分呈线性相关。结论：老龄冠心病患者冠状动脉钙化程度与其糖化血红蛋白、血肌酐和尿酸水平正相关。

Objective：To investigate the factors correlated to coronary artery calcification（CAC） in eld- erly patients with coronary artery diseases. Methods： This study included 165 patients（ aged 66 - 83 yrs）. The blood biochemical examination and CT coronary artery calcium scans were carried out. Qualitative analysis and quantification about CAC was determined by multislice spiral computed tomography （MSCT） and the Agatston calcium score. The related risk factors to coronary calcification were analyzed by multivariate logistic regression. Results： There were significant difference between CAC group and non-CAC group in the risk factors of SDP, serm creatinine, serm uric acid levels, diabetes and smoking （P = 0. 023-0. 005 ）. Positive correlation was existed between CACS and UA（ r = 0. 652, P 〈 0. 05 ）, CACS and Cr（ r = 0. 715, P 〈 0. 05 ）, CACS and HbA1 e （ r = 0. 663, P 〈 0. 05 ）. The Age, SDP, diabetes, serum creatinine, serum uric acid 1 evels, smoking were independent risk factors of CAC（ OR = 1. 032-1. 732 ,P = 0. 015-0. 035 ） by multivariate logistic regression analysis. Conclusion： The degree of coronary artery calcification is positively correlated with the level of glyco- sylated hemoglobin, serum creatinine and uric acid in elderly patients with coronary heart disease.