老年冠心病与少肌症的相关性研究

The study of the relation between coronary artery disease and sarcopenia in the elderly

目的探讨老年冠心病与少肌症的相互关系,为临床冠心病的防治工作开拓新的思路。方法随机选取109例心内科拟诊为冠心病的胸痛患者,根据冠状动脉造影检査结果,分为冠心病组及非冠心病组;根据双能X线骨密度检査结果分为少肌症组与非少肌症组,比较男性及女性少肌症组与非少肌症组之间的冠心病发病率的差异,进一步比较两组间的冠脉粥样硬化情况,分析肌肉量各个测定部位在冠心病预测中的意义。结果①男性少肌症组与非少肌症组相比,两组间的冠心病发病率差异无统计学意义(P=0.64,P>0.05)②女性少肌症组与非少肌症组相比,前者的冠心病发病率高于后者,两组间的冠心病发病率差异有统计学意义(P=0.01,P<0.05);③女性冠心病患者中少肌症组与非少肌症组间冠脉硬化轻重度发病率比较,少肌症组的冠脉硬化严重程度较非少肌症组发病率高,两组间的冠脉硬化轻重度发病率有统计学意义(P=0.03,P<0.05);④女性冠心病与相关因素的logistics回归分析结果发现少肌症为影响冠心病危险因素(P=0.043,P<0.05);⑤女性少肌症组冠脉GS评分轻、重度间身体各个部位肌肉量比较无统计学意义(P>0.05)。结论男性患者冠心病与少肌症无明显相关性;在女性少肌症的冠心病发病率高于非少肌症组,少肌症在冠心病的发病中占重要的地位。

Objectives To probe the relation between coronary artery disease and sarcopenia by comparing the morbility of coronary artery disease and the degree of coronary atherosclerosis between sarcopenia group and non-sarcopenia group in female and male,and to expand new path for preventing coronary artery disease.Methods 109 hospital patients in Cardiology Department were included in the study They were divided into coronary artery disease group and non-coronary artery disease group by coronary angiography.All of them were measured bone mineral density in the corresponding time period.They were divided into sarcopenia group and non-sarcopenia by measuring bone mineral density,and then we analyzed respectively the difference of coronary artery disease morbility and the degree of coronary atherosclerosis between the two groups in female and male in the condition that there was not statistical difference between sarcopenia group and non-sarcopenia group on basic datas.By these results,we probed the relation between the severity degree of coronary artery disease and sarcopenia,the significance of bone density in various detemination positions to predict coronary artery disease and the comparision between sarcopenia and the risk factors of coronary artery disease.Results ①There was not statistical difference beween sarcopenia group and non-sarcopenia group in male on the morbility of sarcopenia（P = 0.64,P0.05）.②There was statistical difference beween sarcopenia group and non-sarcopenia group in female on the morbility of sarcopenia（P =0.01,P〈0.05）.③There was statistical differenc on the Gensini class of coronary heart disease between sarcopenia group and non-sarcopenia group in female（P =0.03,P〈0.05）.④In postmenopausal women,sarcopenia is an independent risk factor for coronary heart disease（P=0.043,P〈0.05）.⑤By comparing lean body mas of each position in different vasculopathy（Gensini class）,we found that lean body mass was not important（P〉0.05）.Conclusions The relation between sarcopenia and coronary heart disease in male didn＇ t exist,but it existed in female.There was statistical difference on the severity of coronary atherosclerosis between sarcopenia group and non-sarcopenia group in female.Sarcopenia maybe had an important rank in the morbility of coronary heart disease.