代谢指标、中医病理因素与急性心肌梗死患者冠状动脉病变支数的Logistics回归分析

The logistic regression analysis of metabolic index,TCM pathological factors and the number of coronary lesions treated in patients with acute myocardial infarction

目的观察代谢指标、中医病理因素对急性心肌梗死患者冠状动脉病变支数的影响。方法经直接经皮冠状动脉介入治疗(PCI)确诊急性心肌梗死患者85例,以单支病变与多支病变分别作为因变量,以原发性高血压病史、糖尿病病史、吸烟史、中医病理因素、糖化血红蛋白(Hb A1c)以及脂代谢指标作为自变量,分别做二分法和多项法Logistics回归分析。结果年龄是多支病变的危险因素(P<0.05,B>0),Hb A1c>7.5%是原发性高血压、血瘀患者发生多支病变的保护性因素(P<0.05,B<0),低密度脂蛋白胆固醇(LDL-C)是合并中医血瘀证候的原发性高血压患者发生多支病变的高危因素(P<0.05,B>0);对估算模型概率有贡献的主因子有年龄、糖尿病病史、吸烟史、痰湿、甘油三酯(TG)和高密度脂蛋白胆固醇(HDL-C)等(P<0.05),其中吸烟史和HDL-C是对模型真正有统计学贡献的因素。结论年龄是急性心肌梗死多支病变的危险因素,Hb A1c>7.5%是原发性高血压、血瘀患者多支病变的保护性因素,LDL-C是原发性高血压合并血瘀证候多支病变的高危因素,年龄、糖尿病病史、吸烟史、痰浊、TG和HDL-C对估算模型概率有贡献。

Objective To observe the effect of metabolism index and TCM pathological factors,on the number of coronary lesions(( hereinafter referred to as the coronary artery) in patients with acute myocardial infarction.Methods 85 patients with acute myocardial infarction were diagnosed by direct percutaneous coronary intervention( PCI),the single and multiple coronary artery lesions as the dependent variable,taking the history of essential hypertension,diabetes mellitus history,smoking history,TCM pathology,glycosylated hemoglobin( HbA 1 c) and lipid metabolism as independent variables,then the logistic regression analysis of dichotomy and multiple were respectively performed. Results Age was a risk factor for multiple coronary lesion( P < 0. 05,B > 0). HbA 1 c > 7. 5% was the protective factor of multiple coronary lesion of hypertension,blood stasis syndrome of patients( P < 0. 05,B < 0).Low density lipoprotein cholesterol( LDL-C) was a high risk factor of multiple coronary lesion in hypertensive patients complicated with blood stasis syndrome( P < 0. 05,B > 0). The main factors contributing to the estimation of model probability include age,history of diabetes,smoking,phlegm dampness,triglyceride( TG) and high density lipoprotein cholesterol( HDL-C)( P < 0. 05). The smoking history and HDL-C were the real statistically significant contributors to the model. Conclusion Age is a risk factor for multiple coronary lesions. HbA 1 c > 7. 5% is the protective factor of multiple coronary lesion of hypertension,blood stasis syndrome of patients. LDL-C is a high risk factor of multiple coronary lesions in hypertensive patients complicated with blood stasis syndrome. The main factors contributing to the estimation of model probability include age,history of diabetes,smoking,phlegm dampness,TG and HDL-C.