合并高甘油三酯腰围表型的冠心病患者冠脉病变特点

Coronary Characteristics of Patients with Coronary Heart Disease and Hypertriglyceridemic-waist Phenotype

目的:探讨合并高甘油三酯腰围表型(HTWP)的冠心病(CHD)患者的临床特征和冠状动脉病变特点。方法:回顾性分析2007年9月-2011年12月昆明医科大学第二附属医院心内科收治的459例CHD患者的临床特征和冠状动脉病变特点,所有患者均经冠脉造影诊断为CHD。根据甘油三酯(TG)和腰围(WC)分为HTWP组(226例)和非HTWP组(233例),比较两组患者的一般情况。结果:HTWP组的腰围、臀围、体重指数(BMI)、收缩压(SBP)、平均动脉压(MAP)、脉压差(PP)、低密度脂蛋白胆固醇(LDL-C)、甘油三酯(TG)、空腹血糖(FBG)、餐后2 h血糖(2 h PG)、腰围甘油三酯乘积指数(WTindex)、纤维蛋白原(FIB)、游离脂肪酸(FFA)分别为(95.68±6.48)cm、(99.53±6.96)cm、(28.54±19.87)kg/m^2、(130.44±18.30)mm Hg、(96.37±11.72)mm Hg、(50.87±14.46)mm Hg、(2.92±0.89)mmol/L、(2.86±1.71)mmol/L、(5.74±1.59)mmol/L、(8.63±4.35)mmol/L、(76.10±24.23)、(4.35±2.28)g/L、(112.99±104.55)μ g/m L,均显著高于非HTWP组的(83.16±4.50)cm、(90.37±5.21)cm、(22.93±2.59)kg/m^2、(123.16±12.90)mm Hg、(90.82±9.04)mm Hg、(48.51±10.77)mm Hg、(2.32±0.72)mmol/L、(1.19±0.32)mmol/L、(5.22±1.28)mmol/L、(6.23±2.46)mmol/L、(39.46±13.00)、(2.95±1.27)g/L、(81.13±72.63)μ g/m L,差异均有统计学意义(P<0.05),HTWP组的脂联素(APN)为(5.20±4.89)mg/L,显著低于非HTWP组的(8.77±6.41)mg/L,差异有统计学意义(P<0.05),冠状动脉积分(CAS)为(11.80±7.51)分,显著高于非HTWP组的(3.97±1.53)分,差异有统计学意义(P<0.05)。多元回归分析显示,TG、FFA、APN、WTindex与CAS均相关(P<0.05)。结论:合并HTWP的CHD患者临床特征及冠状动脉病变更为严重,且冠状动脉积分与WTindex、TG、FFA、APN相关。

Objective： To study the combination of high triglyceride waist phenotype （ HTWP ） of coronary heart disease （ CHD ） clinical and coronary angiographic features of patients.Method： Retrospective analysis of the clinical and coronary angiographic features in 459 CHD patients from September 2007 to December 2011 in our hospital were admitted todepartment of cardiology, all patients were diagnosed coronary heart diseas by coronary angiography.All patients were divided into HTWP group （ n---226 ） and non HTWP group （ n=233 ） by the levele of triglyceride and waist circumference, general data of the two groups were compared.Result： The level of waist circumference, hip eireurnference, body mass index, systolic pressure, mean arterial pressure, pulse pressure, low- density lipoprotein cholesterol, triglycerides, fasting blood glucose, 2 hours postprandial glucose, waist circumference lriglyceride product index, fibrinogen, free fatty acids in HTWP group were （95.68±6.48）cm、（99.53±6.96）cm、（28.54±19.87）kg/m2、（130.44±18.30）mm Hg、（96.37±11.72）mm Hg、（50.87±14.46）mm Hg、（2.92±0.89）mmol/L、（2.86±1.71）mmol/L、（5.74±1.59）mmol/L、（8.63±4.35）mmol/L、（76.10±24.23）、（4.35±2.28）g/L、（112.99±104.55）μg/mL,, which were higher than （83.16±4.50）cm、（90.37±5.21）cm、（22.93±2.59）kg/m2、（123.16±12.90）mm Hg、（90.82±9.04）mm Hg、（48.51±10.77）mm Hg、（2.32±0.72）mmol/L、（1.19±0.32）mmol/L、（5.22±1.28）mmol/L、（6.23±2.46）mmol/L、（39.46±13.00）、（2.95±1.27）g/L、（81.13±72.63）μg/mL in non HTWP group, the differences were statistically significant （ p〈0.05 ）, adiponectin （ APN ） of HTWP group was （ 5.20 ± 4.89 ） mg/L, significantly lower than （ 8.77 ± 6.41 ） mg/L in non HTWP group, the difference was statistically significant （P〈0.05）, thecoronary artery score （ CAS ） was （ 11.80 ± 7.51 ） points, which was significantly higher than （ 3.97 ± 1.53 ） points that of the non HTWP group, the difference was statistically significant （ P〈0.05 ） .Triglyceride, free fatty acids, adiponectin, waist circumference, triglyceride product were related with coronary artery scores （P〈0.05） . Conclusion： Clinical character and coronary artery scores are more severity in patients with HTWP and CHD, waist circumference, triglyceride product, triglyceride, free fatty acids, adiponectin are related with coronary scores.