体质指数对无阻塞性冠状动脉病变胸痛患者冠脉血流储备的影响

Effect of Body Mass Index on Coronary Blood Flow Reserve in Patients with Chest Pain without Obstructive Coronary Artery Disease

分析体质指数(BMI)对无阻塞性冠状动脉病变胸痛患者冠脉血流储备(CFR)的影响。回顾性分析2019年6月~2021年6月期间该院收治的130例无阻塞性冠状动脉病变胸痛患者的临床资料,依据患者的CFR水平将其分为冠状动脉微循环障碍组(简称障碍组,CFR<2.5,n=78)和对照组(CFR≥2.5,n=52),比较两组患者的各项一般资料和临床资料,对有统计学意义的因素进一步行Logistic多因素回归分析,分析无阻塞性冠状动脉病变胸痛患者CFR降低的危险因素,并Pearson分析体质指数与各危险因素的相关性。障碍组患者的男性、BMI≥24 kg/m^(2)、肥胖、腰围>80 cm、低密度脂蛋白胆固醇(LDL-C)>2.8 mmol/L、胰岛素>8 U/mL、同型半胱氨酸(Hcy)>9μmol/L、心外膜脂肪组织(EAT)>3 mm、平均血流速度(MFV)<70 cm/s的发生率均高于对照组,差异有统计学意义(P<0.05)。Logistic多因素回归分析显示男性、BMI≥24 kg/m^(2)、肥胖、腰围>80 cm为无阻塞性冠状动脉病变胸痛患者CFR降低的危险因素(P<0.05)。体质指数与男性、肥胖、腰围均存在正相关(P<0.05)。体质指数为无阻塞性冠状动脉病变胸痛患者CFR降低的独立危险因素,采取有效措施调控患者的体质指数、肥胖和腰围对改善CFR水平有重要意义。

To investigate the effect of body mass index(BMI)on coronary blood flow reserve(CFR)in patients with chest pain without obstructive coronary artery disease,the clinical data of 130 patients with chest pain without obstructive coronary artery disease admitted to the authors'hospital from June 2019 to June 2021 were retrospectively analyzed.Patients were divided into coronary microcirculation disorder group(CFR<2.5,n=78)and control group(CFR≥2.5,n=52)according to their CFR level.The general data and clinical data of the two groups were compared,and Logistic multifactor regression analysis was performed for statistically significant factors to analyze the risk factors of reduced CFR in patients without obstructive coronary artery disease chest pain,and Pearson analysis was performed to analyze the correlation between body mass index and risk factors.Patients in the disorder group were male,BMI≥24 kg/m^(2),obesity,waist circumference>80 cm,LDL-C>2.8 mmol/L,insulin>8 U/mL,homocysteine(Hcy)>9μmol/L,epicardial adipose tissue(EAT)>3 mm,mean velocity of blood flow(MFV)<70 cm/s was higher than that of control group,and the difference was significant(P<0.05).Logistic multivariate regression analysis showed that male,BMI≥24 kg/m^(2),obesity,waist circumference>80 cm were risk factors for CFR reduction in patients without obstructive coronary artery disease chest pain(P<0.05).Body mass index was positively correlated with male,obesity and waist circumference(P<0.05).Body mass index is an independent risk factor for CFR reduction in patients with chest pain without obstructive coronary artery disease.Effective measures to regulate body mass index,obesity and waist circumference are of great significance to improve CFR level.