2007-2017年北京某医院青年冠心病患者的临床指标特征及变化趋势

Characteristics and changes in young adults hospitalized with coronary heart disease from 2007 to 2017

目的分析青年冠心病的临床指标特征及变化趋势。方法收集2007年1月至2017年12月北京安贞医院首次住院且出院第一诊断为冠心病的病例150846例,根据年龄分为青年冠心病(<45岁)、中年冠心病(45~64岁)、老年冠心病(≥65岁)。收集患者的一般资料[性别、年龄、收缩压(systolic blood pressure,SBP)、舒张压(diastolic blood pressure,DBP)、心率(heart rate,HR)]、实验室检查结果[甘油三酯(triglyceride,TG)、总胆固醇(total cholestero,TC)、高密度脂蛋白胆固醇(high density lipoprotein cholesterol,HDL-C)、低密度脂蛋白胆固醇(low density lipoprotein cholesterol,HDL-C)、血尿酸(uricacid,UA)、同型半胱氨酸(homocysteine,HCY)和糖化血红蛋白(HbA1C)]。结果与中、老年冠心病比较,青年冠心病患者TG(2.31±2.03)mmol/L、TC(1.24±4.38)mmol/L、LDL-C(2.70±1.01)mmol/L、UA(378.1±95.2)μmol/L、HCY(18.0±11.8)μmol/L水平最高(F=1850.499,F=132.331,F=190.149,F=649.552,F=155.630,P<0.001),HDL-C(0.92±0.21)mmol/L最低(F=1486.654,P<0.001)。与青年女性比较,青年男性冠心病患者TG(2.35±2.05)mmol/L(t′=7.66,P<0.001)、HbA1c(6.34±1.89)%(t′=6.356,P<0.001)、UA(384.7±92.4)μmol/L(t′=28.790,P<0.001)、HCY(18.46±11.93)μmol/L(t′=17.732,P<0.001)水平高,HDL-C(0.91±0.20)mmol/L(t′=15.676,P<0.001)水平低。青年冠心病患者TC、LDL-C水平呈逐年降低的趋势(4.45±1.16)降至(4.30±1.26);(2.88±1.02)降至(2.62±1.09),趋势P<0.001)。结论青年男性冠心病患者血脂异常程度最严重且同时合并高尿酸与高同型半胱氨酸血症。

Objective To analyze the characteristics and changes in young adults hospitalized with coronary heart disease.Methods From January 2007 to December 2017,a total of 150,846 cases with coronary heart disease initially diagnosed in Beijing Anzhen Hospital were divided into group A(patients aged<45 years),group B(patients aged from 45-64 years),and group C(patients aged≥65 years)).Patients’general information[gender,age,systolic blood pressure(SBP),diastolic blood pressure(DBP),heart rate(HR)],laboratory test results[Triglyceride,TG),total cholesterol(TC),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(HDL-C),blood uric acid(Uricacid,UA),homocysteine(HCY)and glycated hemoglobin(HbA1 C)]were collected and analyzed.Results Compared with those in group B and C,the levels of TG(2.31±2.03)mmol/L,TC(1.2.4±4.38)mmol/L,LDL-C(2.70±1.01)mmol/L,UA(378.1±95.2)μmol/L and HCY(18.0±11.8)μmol/L were higher in group A(F=1850.499,F=132.331,F=190.149,F=649.552,F=155.630,P=0.000).,but HDL-Clower(F=1486.654,P=0.000).Compared with young females with coronary heart disease,young male patients with coronary heart disease had high TG(2.35±2.05)mmol/L(t=7.66,P=0.000),HbA1 c(6.34±1.89)%(t=6.356,P=0.000),UA(384.7±92.4)μmol/L(t=2.8.790,P=0.000),HCY(18.46±11.93)μmol/L(t=17.732,P=0.000)but lower HDL-C(0.91±0.20)mmol/L(t=15.676,P=0.000).The levels of TC and LDL-C in coronary heart disease in young patients also decreased year by year[from(4.45±1.16)to(4.30±1.26)mmol/L;from(2.88±1.02)to(2.62±1.09)mmol/L,trend P=0.000].Conclusion Young male patients with coronary heart disease not only have the most severe dyslipidemia,but also often high uric acid and hyperhomocysteinemia.