冠状动脉粥样硬化严重程度与其危险因素的相关性研究

Relationship between the severity of coronary atherosclerosis and its risk factors

目的研究冠状动脉动脉粥样硬化严重程度与其危险因素的相关性。方法将2018年9月~2020年1月在哈尔滨医科大学附属第一医院心内、外科住院并且首诊确诊或疑似冠心病的322例患者作为研究对象,将其分为冠心病组(n=217)和非冠心病组(n=105),比较两组间基础资料的差异。将Gensini积分作为评估冠状动脉粥样硬化严重程度的指标,通过多元线性回归(逐步回归法)分析与冠状动脉硬化严重程度相关的危险因素,并建立线性回归方程,用ROC曲线分析危险因素对冠心病的预测价值。结果年龄、吸烟年限、高血压年限、糖尿病年限、饮酒年限、纤维蛋白、谷氨酰转肽酶、高密度脂蛋白在冠心病组和非冠心病组间的差异具有统计学意义(P<0.05)。Gensini积分与高超敏心肌钙蛋白Ⅰ、高脑钠肽、高密度脂蛋白水平、冠心病家族史、吸烟年限、高血压年限密切相关(P<0.05),建立线性回归方程Y=53.252+27.338×I+24.739×B-30.489×D+11.171×C+0.432×S+0.817×H。从ROC曲线结果可知,吸烟年限、高血压年限、高密度脂蛋白水平预测冠心病的临界值分别为17年、5.5年、1.085 mmol/L(P<0.05)。结论冠状动脉粥样硬化严重程度与高超敏心肌钙蛋白Ⅰ、高脑钠肽、高密度脂蛋白水平、冠心病家族史、吸烟年限和高血压年限显著相关。

Objective To study the correlation between the severity of coronary atherosclerosis and its risk factors.Methods From September 2018 to January 2020,322 patients in the First Affiliated Hospital of Harbin Medical University who were hospitalized in the Department of Cardiology and Cardiac Surgery were diagnosed or suspected of coronary heart disease at the first diagnosis were included as the research objects.They were divided into two groups,the coronary heart disease group(n=217)and the non-coronary heart disease group(n=105).The differences of basic data were compared between the two groups.The Gensini score was used as an index to evaluate the severity of coronary atherosclerosis,and the risk factors related to the severity of coronary atherosclerosis were analyzed through multiple linear regression(stepwise regression),and a linear regression equation was established.The ROC curve was used to analyze the predictive value of risk factors for coronary heart disease.Results Age,years of smoking,years of hypertension,years of diabetes,years of drinking,fibrin,glutamyl transpeptidase,and high-density lipoprotein were significantly different between the coronary heart disease group and the non-coronary heart disease group(P<0.05).Gensini score was closely related to hypersensitivity cardiac troponin I,high brain natriuretic peptide,high-density lipoprotein levels,family history of coronary heart disease,years of smoking,and years of hypertension(P<0.05).A linear regression equation was established,Y=53.252+27.338×I+24.739×B-30.489×D+11.171×C+0.432×S+0.817×H.From the results of the ROC curve,it was found that the cut-off values of smoking years,hypertension years,and high-density lipoprotein levels for predicting coronary heart disease were 17 years,5.5 years,and 1.085 mmol/L,respectively(P<0.05).Conclusion The severity of coronary atherosclerosis is significantly related to high-hypersensitivity cardiac troponin I,high-brain natriuretic peptide,high-density lipoprotein levels,family history of coronary heart disease,years of smoking and years of hypertension.