早发冠心病的易患因素和冠脉造影及心功能特点研究

The Predisposing Factors of Premature Coronary Heart Disease and the Characteristics of Coronary Angiography and Cardiac Function

目的探讨早发冠心病患者的易患因素和冠脉造影及心功能特点。方法随机抽取2015年1月至2016年6月在北京安贞医院经冠状动脉造影确诊为冠心病的患者1117例,其中早发冠心病617例(男<55岁,女<65岁),晚发冠心病500例。对两组患者的临床资料进行系统性回顾分析,比较两组患者冠状动脉特点、性别、血脂水平、高血压史、糖尿病史、冠心病家族史、吸烟史、体重指数及心功能的差异。结果早发组在冠心病家族史高于晚发组(P<0.05),早发组在血脂异常、糖尿病低于晚发组(P<0.05)。两组患者在性别、高血压、吸烟史、肥胖比较无差异(P>0.05)。早发组在单支病变高于晚发组,在三支病变低于晚发组(P<0.05)。早发组的左室射血分数(LVEF)显著高于晚发组(P<0.01)。结论冠心病家族史是早发冠心病的独立危险因素。早发冠心病患者单支病变多于晚发组,并且早发组冠心病患者心功能强于晚发组。

Objective To explore the predisposing factors, coronary angiography and cardiac function in patients with premature coronary heart disease. Methods From January 2015 to June 2016 in Beijing Anzhen Hospital, we randomly selected study subjects diagnosed by coronary angiography in 1117 patients with coronary heart disease, including 617 cases of premature coronary heart disease （ male 〈 55, female 〈 65 years） ,500 cases of late-onset coronary artery disease. Retrospectively analysis of the clinical data of two patients was conducted, and the difference between the two groups of patients with coronary artery characteristics, gender, blood lipid levels, hypertension history, diabetes history, family history of coronary heart disease, smoking history, body mass index and heart function were analyzed. Results The family history of CHD in early-onset group was higher than that in late-onset group （ P 〈 0.05 ）, while in early-onset group, dyslipidemia and diabetes were lower than those in late-onset group （ P 〈 0.05 ）. There was no significant difference in gender, hypertension, smoking history and obesity between the two groups （P 〉 0.05）. In the early-onset group, the one vessel lesion was higher than the late onset group, and the three vessel lesion was lower than the late onset group （P 〈 0.05 ）. The left ventricular ejection fraction （LVEF） in premature group was significantly higher than that in late-onset group （ P 〈 0.01 ）. Coudusion Family history of coronary heart disease is an independent risk factor for premature coronary heart disease. Premature coronary heart disease patients has higher rate of single vessel disease than late onset group, and early onset group of patients has stronger coronary heart function than late onset group.