慢性稳定性冠心病患者发生严重心血管疾病的危险因素分析

Risk factors of severe cardiovascular events in patients with chronic stable coronary heart disease

目的探讨慢性稳定性冠心病患者发生严重心血管疾病的危险因素。方法选取明确诊断有慢性稳定性冠心病的患者122例和同期就诊的无冠心病患者160例,分别设为冠心病组和对照组,收集患者一般资料,检测空腹血糖(FBG)、血脂及肾功能等生化指标,行颈动脉血管超声及心-踝血管指数(CAVI)检查。结果冠心病组与对照组在性别、年龄、BMI、FBG、总胆固醇、低密度脂蛋白胆固醇、肾小球滤过率、同型半胱氨酸、肌酐、颈动脉粥样斑块发生率、CAVI比较,差异均有统计学意义(均P<0.05);多因素logistic回归分析显示,高龄、男性、颈动脉粥样斑块、FBG偏高是慢性稳定性冠心病患者发生严重心血管疾病的独立危险因素(均P<0.05)。结论随着颈动脉粥样斑块的形成、FBG水平升高、年龄的增长,慢性稳定性冠心病发生严重心血管疾病的风险逐渐增加。对于有以上危险因素的患者,尤其是男性,需及早干预及治疗,以降低严重心血管疾病的发生风险。

Objective To investigate the risk factors of severe cardiovascular events in patients with stable chronic coronary heart disease(CHD).Methods One hundred and twenty-two patients diagnosed with stable chronic CHD(CHD group)and 160 patients without CHD(control group)were enrolled.Clinical data were collected,fasting blood glucose(FBG),blood lipid and renal function indicators were determined,carotid artery ultrasonography was performed and cardio-ankle vascular index(CAVI)were measured.Results There were significant differences in gender,age,BMI,FBG,TC,LDL-C,GFR,Hcy,Cr,incidence of carotid atherosclerotic plaque and CAVI between the CHD group and the control group(P<0.05,respectively).Multivariate logistic regression analysis revealed that advanced age,male gender,carotid atherosclerotic plaque and elevated FBG were independent risk factors for severe cardiovascular events in patients with stable chronic CHD(P<0.05,respectively).Conclusion For chronic stable CHD patients with advanced age,carotid atherosclerotic plaque and increased FBG level,particularly for males,early intervention and treatment are needed to reduce the risk of severe cardiovascular events.