冠状动脉慢血流的危险因素及冠状动脉病变特点的研究

Risk Factors of Coronary Slow Flow and Characteristics of Coronary Artery Lesions

目的研究冠状动脉慢血流现象(CSFP)患者的危险因素和分析累及冠状动脉病变的特点。方法回顾性收集本院2019年1月—2021年1月因疑似冠心病行冠状动脉造影术的514例患者,分析患者的临床资料、实验室指标及冠状动脉造影结果等相关资料,按照TIMI血流分级分为慢血流组(n=288)和对照组(n=226),比较两组之间的差异,并通过logistics回归分析探讨CSFP患者的危险因素。结果 (1)两组间在性别、民族、吸烟及饮酒史上存在统计学差异(P<0.05)。(2)CSFP组的血红蛋白、游离三碘甲状原氨酸、血肌酐值、血尿酸水平、空腹血糖水平和左室舒张末期大小均高于对照组(P<0.05);而CSFP组的血小板分布宽度、游离甲状腺素、总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、载脂蛋白A1和白蛋白水平均低于对照组(P<0.05);(3)CSFP以三支血管病变最多见,为124例(43.0%),而单支血管病变和双支血管病变病例数一样,均为82例(28.5%)。单支血管病变中最多见的是前降支67例(81.7%),其次是右冠状动脉12例(14.6%),左回旋支较少见;(4)多因素logistic回归分析发现:性别、民族、游离甲状腺素、载脂蛋白A1和白蛋白水平是CSFP患者的独立危险因素。结论 (1)男性、少数民族、游离甲状腺素、载脂蛋白A1和白蛋白水平是CSFP的独立危险因素;(2)CSFP更常见于三支冠状动脉病变组,单支冠状动脉病变者更常见于左前降支。

Objective To study risk factors of the patients with coronary slow flow phenomenon(CSFP) and analyze characteristics of involved coronary artery lesions.Methods Total 514 patients underwent coronary angiography and suspected for coronary heart disease in our hospital from January 2019 to January 2021 were retrospectively collected.The clinical data, laboratory indicators and results of coronary angiography were analyzed, and divided into CSFP group(n=288) and control group(n=226) according to TIMI flow grades to compare their differences.Risk factors for CSFP were explored through logistics regression analysis.Results(1) There were statistical differences on sex, ethnicity, smoking and alcohol consumption history between two groups(P<0.05).(2)Hemoglobin, triiodothyronine, serum creatinine value, serum uric acid level, fasting glucose level and left ventricular end-diastolic size were higher in CSFP group than control group, while levels of mean platelet distribution width, tetraiodothyronine, total cholesterol, high and low density lipoprotein cholesterol, apolipoprotein A1 and albumin were lower in CSFP group(P<0.05).(3)Three-vessel lesion was the most common type in CSFP,accounting for 124 cases(43.0%),while single-vessel and double-vessel lesions possessed the same number of 82 cases(28.5%).The most common vessel among single-vessel lesions was anterior descending artery with 67 cases(81.7%),followed by right coronary artery with 12 cases(14.6%) and circumflex artery with scarcity.(4)Multivariate logistic regression analysis showed gender, ethnicity, tetraiodothyronine, apolipoprotein A1 and albumin levels were independent risk factors for CSFP.Conclusions(1) Male, ethnic minority, tetraiodothyronine, apolipoprotein A1 and albumin levels are independent risk factors for CSFP.(2)CSFP seems common in three-vessel lesion patients, while the left anterior descending branch would be often involved in single-vessel lesion patients.