合并强直性脊柱炎的急性冠状动脉综合征患者的传统危险因素特点

Traditional risk factors of acute coronary syndrome complicated with ankylosing spondylitis

目的分析合并强直性脊柱炎(AS)的急性冠状动脉综合征(ACS)患者的传统危险因素特点。方法回顾性分析2002年1月至2017年6月在首都医科大学附属北京安贞医院住院的76例合并AS的ACS患者的临床资料(观察组),同期完全随机选取住院的未合并AS的76例ACS患者的临床资料(对照组)。比较2组患者发生ACS传统危险因素方面的差异。结果观察组男性比例高于对照组,ACS发病年龄小于对照组[94.7%(72/76)比82.9%(63/76)、(51±10)岁比(56±10)岁],差异有统计学意义(P<0.05)。2组体重指数、心血管病家族史、吸烟史、糖尿病史、高血压史、脑卒中史比例差异均无统计学意义(均P>0.05)。观察组患者的高密度脂蛋内胆固醇(HDL-C)水平明显低于对照组[(0.94±0.22)mmol/L比(1.05±0.23)mmol/L],差异有统计学意义(P<0.05)。2组三酰甘油、总胆固醇、低密度脂蛋白胆固醇(LDL-C)、三酰甘油/HDL-C、总胆固醇/HDL-C及LDL-C/HDL-C比值差异均无统计学意义(均P>0.05)。结论对于早发、尤其是青年男性,以HDL-C降低更为突出的ACS患者,应详细询问病史,排除AS的合并情况。

Objective To analyze the traditional risk factors of acute coronary syndrome （ACS） compli- cated with ankylosing spondylitis （AS）. Methods Clinical data of 76 cases of ACS with AS （observation group） and 76 cases of ACS without AS （control group） in Beijing Anzhen Hospital, Capital Medical University were retrospectively analyzed from January 2002 to June 2017. Traditional risk factors of ACS were compared between groups. Results Male ratio in observation group was significantly higher and age of onset was significantly lower than those in control group[94. 7% （72/76） vs 82. 9% （63/76）, （51 ± 10）years old vs （56 ± 10）years old] （P 〈 0. 05 ）. Body mass index, family history of cardiovascular disease, smoking history, diabetes history, hypertension history and stroke history showed no significant differences between groups（P 〉0.05）. High-density lipoprotein cholesterol （HDL-C） level in observation group was significantly lower than that in control group [ （0. 94 ± 0. 22） mmol/L vs （ 1.05 ±0. 23 ） mmol/L ] （ P 〈 0. 05 ）. Levels of triacylglycerol, total cholesterol, low-density lipoprotein cholesterol（LDL-C） , triacylglyeerolfHDL-C, total cholesterol/HDL-C and LDL-C/HDL-C showed no significant differences between groups （ P 〉 0. 05 ）. Conclusion Medical history should be carefully collected in ACS patients to exclude AS, especially in premature, young, male ACS patients with low HDL-C level.