合并高三酰甘油腰围表型冠心病患者的冠状动脉评分

Coronary scores of patients with coronary heart disease and hypertriglyceridemic-waist phenotype

目的:探讨合并高三酰甘油腰围表型(HTWP)冠心病(CHD)患者的临床特征和冠状动脉评分。方法:回顾性分析昆明医科大学第二附属医院心内科收治的CHD患者临床特征和冠状动脉评分。共入选830例患者,根据三酰甘油(TG)和腰围(WC)分为四组:A组(合并HTWP)226例、B组(合并高TG血症)150例、C组(合并腹型肥胖)221例、D组(TG/WC正常)233例。结果:四组间收缩压(SBP)、舒张压(DBP)、平均动脉压(MBP)比较差异有统计学意义(F=8.072~9.104,P=0.000);四组间比较总胆固醇(TC)(F=32.560,P=0.000)、高密度脂蛋白胆固醇(HDL-D)(F=9.884,P=0.000)、低密度脂蛋白胆固醇(LDL-D)(F=21.944,P=0.000)差异有统计学意义;四组间比较空腹血糖(FBG)(F=6.607,P=0.000)、餐后2 h血糖(2h PG)(F=5.200,P=0.002)差异有统计学意义;四组间比较纤维蛋白原(Fib)、游离脂肪酸(FFA)、脂联素(APN)(F=2.61~3.49,P=0.016~0.048)差异有统计学意义;四组间比较冠状动脉评分(F=8.814,P=0.000)差异有统计学意义。结论:合并HTWP的CHD患者代谢紊乱、炎性反应及冠状动脉病变更为严重。

Objective To investigate the clinical characteristics and coronary scores of patients with coronary heart disease（ CHD） and hypertrglyceridemic-waist phenotype（ HTWP）. Method This was a retrospective cohort study. Patients were admitted to department of cardiology of the second affiliated hospital of kunming medical university with CHD. A total of 830 patients. All patients were divided into four groups by the levels of triglyceride and waist circumference： A group with the hypertriglyceridemic-waist phenotype,a total of 226 cases; B group with combined hypertriglyceridemia,a total of 150 cases; C group with combined abdominal obesity,a total of 221 cases; D group without combined hypertriglyceridemia and combined abdominal obesity,a total of 233 cases. Results There was significant difference the systolic blood pressure、the diastolic blood pressure and the mean artery pressure in groups（ F = 8. 072 ~ 9. 104,P = 0. 000）. There was significant difference the total cholesterol、high-density lipoprotein cholesterol、low-density lipoprotein cholesterol in the foure groups（ F = 9. 884 ~ 32. 560,P = 0. 000）. There was significant difference fasting blood glucose、2 hour postprandial glucose in the foure groups（ F = 5. 200 ~ 6. 607,P = 0. 000 ~0. 002）. There was significant difference the fibrinogen、free fatty acides 、Adiponectin in foure groups（ F = 2. 61 ~ 3. 49,P =0. 016 ~ 0. 048）. Comparasion of coronary scores in groups： there was a significant differentce the coronary scores in groups（ F =8. 814,P = 0. 000）. Conclusion Patients with hypertriglyceridemic-waist phenotype and coronary heart disease deteriorates metabolic disorders、inflammatory indicator and coronary artery disease.