不同年龄男性患者颈动脉粥样硬化与冠脉病变的相关性分析

Correlation analysis of carotid atherosclerosis and coronary artery disease in male patients of different ages and its influencing factors

目的探讨男性不同年龄患者颈动脉粥样硬化与冠脉病变的相关性分析及影响因素。方法随机选取武汉科技大学附属天佑医院心血管内科2019年12月至2021年12月期间冠脉造影阳性男性患者268例,按照年龄分为老年组(n=146)和非老年组(n=122),观察两组间颈动脉内膜-中膜厚度(CIMT)的差异、冠状动脉Gensini评分的差异,并评估二者之间的相关性及其危险因素。结果老年组收缩压、舒张压、IMT值、冠脉病变程度、LDL-C值明显高于非老年组,差异有统计学意义(t=1.906、1.284、1.245、1.497、0.943,P<0.05)。老年组中随着Gensini评分增加,IMT值逐级递增,差异有统计学意义(P<0.05),且随着Gensini评分增加,吸烟、伴有高血压、糖尿病患者较非老年组明显增多;非老年组中Gensini评分与IMT比较,差异无统计学意义(t=1.215、2.194,P>0.05)。Pearson相关性分析结果表明:老年组Gensini评分分级与IMT水平呈现正相关性(P<0.05),非老年组Gensini评分分级与IMT水平无相关性(P>0.05)。Logistic回归模型,结果显示,Gensini评分3级、LDL-C≥2.6 mmol/L、高血压病程>10年是颈动脉粥样硬化合并冠脉病变的独立危险因素(P<0.05)。结论颈动脉粥样硬化与老年男性冠脉病变呈强相关性,受到的影响因素较多,加强患者颈动脉内膜中膜厚度(CIMT)增厚、颈动脉粥样硬化测定能预测老年男性冠心病的发生。

Objective To investigate the correlation analysis and influencing factors of carotid atherosclerosis and coronary artery disease in male patients of different ages.Methods A total of 268 male patients with positive coronary angiography from December 2019 to December 2021 in the Department of Cardiovascular Medicine,Tianyou Hospital Affiliated to Wuhan University of Science and Technology were randomly selected and divided into an elderly group(n=146)and a non-elderly group(n=122)according to age.The difference in carotid intima-media thickness(CIMT)and coronary Gensini score between the two groups was compared,and the correlation between the two groups and their risk factors was evaluated.Results The systolic blood pressure,diastolic blood pressure,IMT value,degree of coronary artery disease,and LDL-C value in the elderly group were significantly higher than those in the non-elderly group,and the differences were statistically significant(t=1.906,1.284,1.245,1.497,0.943,P<0.05).In the elderly group,with the increase of the Gensini score,the IMT value increased gradually,and the difference was statistically significant(P<0.05).With the increase of the Gensini score,the number of patients withsmoking,hypertension and diabetes increased significantly compared with the non-elderly group.There was no significant difference between Gensini score and IMT in the elderly group(t=1.215,2.194,P>0.05).The results of Pearson correlation analysis showed that there was a positive correlation between the Gensini score and the IMT level in the elderly group(P<0.05),but there was no correlation between the Gensini score and the IMT level in the non-elderly group(P>0.05).Logistic regression model showed that Gensini score 3,LDL-C≥2.6 mmol/L,and hypertension duration>10 years were independent risk factors for carotid atherosclerosis complicated with coronary artery disease(P<0.05).Conclusion Carotid atherosclerosis has a strong correlation with coronary artery disease in elderly men,and is affected by many factors.Strengthened carotid intima-media thickness(CIMT)thickening and carotid atherosclerosis assay can predict the occurrence of coronary artery disease in elderly men.