低骨密度与非糖尿病性冠心病患者冠状动脉病变的相关性

Correlation between low bone mineral density and severity of coronary artery lesion in patients with non-diabetic coronary heart disease

目的探讨低骨密度(包括骨质疏松与骨量减少)与非糖尿病性冠心病患者冠状动脉病变严重程度的相关性。方法入选156例因胸痛入院的非糖尿病患者,收集一般临床资料和常规检验指标结果,采用冠状动脉造影明确冠心病,按照冠状动脉病变血管数进行分组:无冠状动脉病变组(非冠心病组)、单支病变组、双支病变组、三支病变组。64排螺旋CT扫描机测定冠状动脉钙化积分,按冠状动脉钙化积分分组:无钙化组(<10分)、轻度钙化组(10~100分),中度钙化组(100~400分)、重度钙化组(>400分)。双能X线骨密度仪测定骨密度水平,根据检查结果分为骨质疏松组、骨量减少组和骨量正常组,比较三组间冠状动脉病变程度的差异。结果随着冠状动脉狭窄程度和钙化程度的加重,低骨密度发病率呈升高趋势。骨量减少组和骨质疏松组冠状动脉狭窄程度和钙化程度明显高于骨量正常组,三组间比较有统计学差异(P<0.01)。结论低骨密度可能是血糖正常的冠心病患者冠状动脉狭窄及钙化程度的独立危险因素。

Aim To investigate the association between low bone mineral density （BMD） and severity of coronary artery lesion patients with non-diabetic coronary heart disease. Methods A total of 156 patients with non-diabetic coronary heart disease （CHD） with chest pain were enrolled in the study, clinical characteristic of patients was recorded, coronary artery lesion was determined by coronary angiography, the patients were grouped according to the number of coronary artery lesions： non-coronary artery lesion group, single coronary artery lesion group, double coronary artery lesion group, three coronary artery lesion group. Coronary artery clacification （CAC） was evaluated by 64 slice spiral CT, patients were grouped according to coronary artery calcification score： no calcification group （〈 10 score）, mild calcification group （ 10～ 100 score）, moderate calcification group （ 101 ～400 score）, severe calcification group （ 〉400 score）. In ad- dition, the bone mineral density （BMD） was measured by dual energy X-ray absorptiometry （DXA）, according to the resuits, patients were divided into osteoporosis group, osteopenia group and normal bone group, and the difference of the degree of coronary artery lesions between the three groups was compared. Results With the severity of coronary artery calcification and coronary stenosis, the incidence of BMD were increased. The severity of coronary artery calcification and coronary stenosis in osteopenia group and osteoporosis group were significantly higher than that in normal group, there were statistically significant differences among the three groups （P〈0.01）. Conclusion Low bone mineral density can be considered as an independent factor of coronary artery calcification and coronary stenosis in coronary heart disease patient without diabetes.