稳定性冠心病患者发生冠状动脉三支血管病变的相关因素分析

Related factors of three-vessel disease in patients with stable coronary artery disease

目的分析稳定性冠心病(SCAD)患者发生三支血管病变的相关因素。方法该研究为横断面研究。收集2019年5月至2020年4月复旦大学附属中山医院诊断为SCAD的447例患者的临床资料,其中冠状动脉单支血管病变组108例,二支血管病变组136例,三支血管病变组203例。以单支和三支血管病变组为研究对象,采用单因素分析比较两组患者一般资料和生化指标的差异,并采用多因素logistic回归分析SCAD患者发生三支血管病变的相关因素。结果311例患者中,男性244例(78.5%),女性67例(21.5%);年龄57(64,69)岁。单支血管病变组与三支血管病变组SCAD患者的糖尿病史(χ^(2)=7.75,P=0.005)以及尿酸(Z=-2.10,P=0.036)、糖化血红蛋白(Z=-2.77,P=0.006)、高密度脂蛋白胆固醇(HDL-C)(Z=-2.99,P=0.003)水平差异有统计学意义。多因素分析结果显示,血尿酸(OR=1.01,95%CI:1.00~1.01,P<0.05)水平较高,HDL-C水平较低(OR=3.29,95%CI:1.23~8.85,P<0.05)是SCAD患者发生三支血管病变的相关因素。结论高血尿酸水平和低HDL-C水平是SCAD患者发生三支血管病变的相关因素。

Objective To analyze the risk factors of three-vessel disease(TVD)in patients with stable coronary artery disease(SCAD).Methods The clinical data of 447 patients with SCAD diagnosed in Zhongshan Hospital from May 2019 to April 2020 were retrospectively analyzed,including 108 cases with the single-vessel disease(SVD),136 cases with the two-vessel disease,and 203 cases with three-vessel disease.The general data and hematological indexes were compared between patients with SVD and those with TVD;the related factors for TVD in SCAD patients were analyzed with univariate and multivariate logistic regression.Results There were 244 males(78.5%)and 67 females(21.5%)with a median age of 57 years(64,69).Univariate analysis showed that there were significant differences in diabetes history(χ^(2)=7.75,P=0.005),uric acid(Z=-2.10,P=0.036),glycosylated hemoglobin(Z=-2.77,P=0.006)and high density lipoprotein cholesterol(HDL-C)(Z=-2.99,P=0.003)levels between SVD and TVD groups.Multivariate analysis showed that the high level of blood uric acid(OR=1.01,95%CI:1.00-1.01,P<0.05)and the low level of HDL-C(OR=3.29,95%CI:1.23-8.85,P<0.05)were related risk factors of TVD.Conclusion High blood uric acid level and low HDL-C level are related factors for TVD in patients with SCAD.