冠状动脉CTA对青年人冠心病常见危险因素控制策略的影响

Influence of coronary CT angiography findings on prevention strategies of risk factors of coronary artery disease in the young

目的探讨冠状动脉CTA结果对青年人冠心病常见危险因素控制策略的影响。方法选择从2013年9月至2015年9月期间本院行冠状动脉CTA且存在冠心病常见危险因素的青年人136例,根据其冠状动脉CTA结果分为正常组53例,轻度病变组45例,中度病变组38例。收集3组人群的基线资料及CTA后3月对应资料,对比分析冠心病危险因素后续控制情况及相关药物治疗的变化。结果轻度病变组及中度病变组患者行冠脉CTA后收缩压、舒张压、空腹血糖、总胆固醇、甘油三酯、低密度脂蛋白、高敏C反应蛋白较行冠脉CTA前差异有统计学意义(P<0.05),相应服药比例明显增加(P<0.05);行冠脉CTA后,轻度病变组及中度病变组患者同正常病变组比较,以上指标差异有统计学意义(P<0.05),相应服药比例及戒烟率明显增加(P<0.05);与轻度病变组患者比较,中度病变组患者的收缩压、舒张压下降更明显,服药比例、戒烟率更高,差异有统计学意义(P<0.05)。3组患者CTA前后的体质指数、2 h血糖差异无统计学意义(P>0.05)。结论冠状动脉CTA结果对青年人冠心病危险因素控制和药物治疗有直接影响,对预防冠心病有指导价值。

Objective To observe influence of coronary CT angiography （CTA） findings on control of risk factors of coronary artery disease （CAD） and preventive medical treatment in the young. Methods 136 cases of young people with risk factors of CAD were divided into three groups according to findings of coronary CTA, namely 53 cases in the normal group, 45 cases in the mild lesion group and 38 cases in the moderate lesion group. Baseline data of the three groups and corresponding data three months after CTA were collected to contrast and analyze risk factors of CAD for subsequent control situation and the related changes in drug treatment. Results The difference of systolic blood pressure, diastolic blood pressure, fasting blood glucose, total cholesterol, triglyceride, low-density lipoprotein cholesterol and high-sensitivity c-reactive protein in the mild lesion group and moderate lesion group, which also had higher proportion of taking medicine, and that of berore CTA reaches the significance（P〈0.05）. The difference between the above-mentioned indexes of the mild and moderate lesion group and that of the normal group after CTA reached the significance, and they had higher proportion of taking medicine and quitting smoking than the normal group（P〈0.05）. What＇s more, systolic blood pressure, diastolic blood pressure in moderate lesion group decreased significantly than that in the mild lesion group（P〈0.05）. In the three groups, there was no difference in body mass index,2h plasma glucose before and after coronary CTA （ P〉 0. 05）. Conclusions The results of coronary CTA have direct influence on the risk factors, control and drug treatment of CHD in young people, and have guiding value for the prevention of CAD.