新疆地区汉族、维吾尔族和回族冠心病患者的临床特征及相关危险因素分析

Correlation analysis of clinical features and risk factors in patients with coronary heart disease in Han,Uygur and Hui ethnic groups in Xinjiang

目的探讨新疆地区维吾尔族、汉族和回族冠心病患者的危险因素和临床特征,并分析与冠心病病变严重程度相关的危险因素。方法选择2018年10月至2019年10月就诊新疆医科大学第一附属医院、行冠状动脉造影确诊为冠心病的823例患者,根据民族分为维吾尔族(167例)、汉族(585例)和回族(71例),并根据冠状动脉Gensini评分评估的病变严重程度分为轻度组(544例)、中度组(176例)和重度组(103例),记录并比较所有患者的一般临床资料、生化指标和冠状动脉造影结果。使用有序分类资料logistic回归分析冠状动脉病变严重程度的相关因素。结果维吾尔族冠心病患者的年龄小于汉族和回族,维吾尔族和回族冠心病患者的体质指数高于汉族,而汉族冠心病患者的血尿酸水平高于维吾尔族和回族,差异均有统计学意义(均为P<0.05)。按冠状动脉病变严重程度分类发现,中度组和重度组的B型利钠肽、D-二聚体、三酰甘油、胱抑素C、空腹血糖和糖化血红蛋白水平等高于轻度组,而高密度脂蛋白胆固醇、白蛋白和糖尿病患病率均低于轻度组,差异均有统计学意义(均为P<0.05)。有序分类资料logistic回归分析显示,在校正年龄、性别、糖尿病史、血小板、平均红细胞血红蛋白含量、D-二聚体、三酰甘油、白蛋白、胱抑素C等混杂因素后,B型利钠肽(OR=1.003,95%CI:1.001~1.005,P<0.05)、糖化血红蛋白(OR=1.312,95%CI:1.053~1.636,P<0.05)是冠状动脉病变严重程度的独立相关危险因素,而高密度脂蛋白胆固醇(OR=0.275,95%CI:0.133~0.569,P<0.05)是其独立相关保护因素。结论在新疆地区冠心病患者中,B型利钠肽和糖化血红蛋白是冠状动脉病变严重程度的独立危险因素,而高密度脂蛋白胆固醇是其独立保护因素。

Objective To explore the differences among ethnic groups in the correlation between the clinical features and risk factors of patients with coronary heart disease(CHD)among Uygur,Han and Hui patients in Xinjiang.Methods The 167 cases of Uygur,585 cases of Han and 71 cases of Hui in the First Affiliated Hospital of Xinjiang Medical University from October 2018 to October 2019 were enrolled.According to the severity of the lesions assessed by the coronary Gensini score,they were divided into mild group(544 cases),moderate group(176 cases)and severe group(103 cases).The general clinical data,biochemical indicators and coronary angiography results of all patients were recorded and compared.Logistic regression of ordered classification data was used to analyze the related factors of the severity of coronary artery disease.Results Classification by ethnicity:the age of CHD patients of Uygur was lower than that of Han and Hui,the body mass index of Uygur and Hui was higher than that of Han,and the blood uric acid level of Han was higher than that of Uygur and Hui,the difference was statistically significant(all P<0.05).Classification according to the severity of coronary artery disease:B-type natriuretic pepetide(BNP),D-dimer,triglyceride,cystatin C,fasting blood glucose and haemoglobin A1c(HbA1c)were higher,while high-density lipoprotein cholesterol(HDL-C),albumin and morbidity rate of diabetes was lower in moderate group and severe group than in mild group,the difference was statistically significant(all P<0.05).The ordered logistic regression analysis of classification data showed that the adjustment for age,gender,history of diabetes,platelets,mean corpuscular hemoglobin,D-dimer,triglyceride and other confounding factors,the BNP(OR=1.003,95%CI:1.001-1.005,P<0.05),HbA1c(OR=1.312,95%CI=1.053-1.636,P<0.05)was the independent associated risk factor of coronary artery lesion severity,HDL-C(OR=0.275,95%CI:0.133-0.569,P<0.05)was the independent protective factor.Conclusions In Xinjiang,BNP and HbA1c are the independent risk factors,while HDL-C is the independent protective factor for the severity of coronary artery disease.