高血压合并冠心病患者发生急性冠状动脉综合征的危险因素分析

Risk Factors of Acute Coronary Syndromes in Patients with Hypertension Complicated with Coronary Heart Disease

目的研究高血压合并冠心病患者发生急性冠状动脉综合征(ACS)的危险因素。方法选择2013年4月至2015年6月河池市第三人民医院心内科接诊的高血压联合冠心病患者120例,依据是否发生ACS分为发生ACS组和未发生ACS组。采用Logistic回归分析高血压合并冠心病患者发生ACS的危险因素。结果发生ACS患者重度高血压的发生率、Ⅳ级高血压的发生率、低密度脂蛋白胆固醇(LDL-C)、原发性同型半胱氨酸(Hcy)和高敏C反应蛋白(hs-CRP)水平显著高于未发生ACS患者[25.00%(15/60)比8.33%(5/60),18.33%(11/60)比6.67%(4/60),(3.4±0.9)mmol/L比(2.8±0.8)mmol/L,(19.9±2.7)μmol/L比(6.6±1.3)μmol/L,(21.3±4.1)mg/L比(9.9±1.1)mg/L],差异有统计学意义(P<0.05)。多元Logistic回归分析结果显示,重度高血压、Ⅲ和Ⅳ级的纽约心脏病协会(NYHA)分级、Hcy、LDL-C、hs-CRP的增高是ACS发生的危险因素(P<0.05)。结论重度高血压Ⅲ和Ⅳ级的NYHA分级、Hcy、LDL-C、hs-CRP的增高是ACS发生的危险因素,所以临床中应对Hcy、LDL-C、hs-CRP水平进行有效控制,以减少ACS的发生。

Objective To analyze the risk factors of acute coronary syndrome in patients with hyperten- sion Complicated with coronary heart disease（CHD）. Methods Total of 120 patients with hypertension com- plicated with CHD in Hechi City Third People＇s Hospital from Apr. 2013 to Jun. 2015 were divided into ACS and without ACS. Logistic review analysis was adopted to analyze the risk factors of ACS in patients with hypertension complicated with CHD. Results Severe hypertension incidence, the incidence of hypertension level IV, low density lipoprotein-cholesterol （ LDL-C ）, homocysteine （Hcy） and high sensitivity C-reactive protein （hs-CRP） of ACS patient were higher than the non-ACS patient [ 25.00% （ 15/60 ） vs 8.33% （5/ 60） ,18.33%（11/60） vs 6.67% （4/60）,（3.4 ±0.9） mmol/L vs （2.8 ±0.8） mmol/L,（19.9 ± 2. 7 ） μmol/L vs （6.6 ± 1.3 ） μmol/L, （21.3 ± 4. 1 ） mg/L vs （9.9 ±1.1 ） mg/L ], the differences were statistically significant（ P 〈0. 05 ）. Multivariate Logistic regression analysis showed that severe hypertension, grade III and IV of New York Heart Association （NYHA） classification, Hcy, LDL-C, and hs-CRP increase are risk factors for ACS（P 〈 0. 05 ）. Conehmion Severe hypertension, grade III and IV of NYHA classifica- tion,Hcy,LDL-C,hs-CRP increase are risk factors for ACS,so we should pay attention to control the Hcy, LDL-C, hs-CRP level in clinical, which can effectively reduce the occurrence of ACS.