新型冠状病毒无症状感染和轻型感染与冠心病患者心绞痛发作的关系研究

Association of novel coronavirus asymptomatic infection and mild infection with angina pectoris attack in patients with coronary atherosclerotic heart disease

目的探究新型冠状病毒无症状感染和轻型感染与冠心病(冠状动脉粥样硬化性心脏病)患者心绞痛发作情况之间的关系。方法回顾性收集2022年12月至2023年1月首都医科大学附属北京安贞医院收治的231例冠心病合并新型冠状病毒无症状感染和轻型感染患者。按新型冠状病毒感染症状类型分为对照组(无症状感染者,115例)和观察组(轻型感染者,116例),比较2组患者的临床特征。新型冠状病毒感染后对患者进行1个月随访,比较2组患者心绞痛发生情况,采用Cox回归模型探讨影响患者心绞痛发生的独立危险因素。结果观察组患者年龄大于,体重指数、D-二聚体、血红蛋白水平低于,慢性肺病比例高于对照组,差异均有统计学意义(均P<0.05)。观察组短期内心绞痛发生风险显著高于对照组(风险比:2.371,95%置信区间:1.373~4.094,P=0.002)。多因素Cox回归分析显示,年龄(风险比:1.065,95%置信区间:1.026~1.106,P=0.001)、冠状动脉病变支数(风险比:1.777,95%置信区间:1.297~2.435,P<0.001)、新型冠状病毒感染症状类型(风险比:1.813,95%置信区间:0.986~3.101,P=0.031)、血红蛋白水平(风险比:0.980,95%置信区间:0.963~0.997,P=0.024)是短期内发生心绞痛的独立危险因素。结论新型冠状病毒轻型感染的冠心病患者较无症状感染者心绞痛事件发生风险高,心绞痛的发生与患者年龄、新型冠状病毒感染症状类型、冠状动脉病变支数、血红蛋白水平独立相关。

Objective To investigate the association between novel coronavirus asymptomatic and mild infection and the occurrence of angina pectoris attack in patients with coronary atherosclerotic heart disease(CHD).Methods Totally 231 cases of CHD combined with novel coronavirus infection asymptomatic and mild infection admitted to Beijing Anzhen Hospital,Capital Medical University,from December 2022 to January 2023 were retrospectively collected.The patients were divided into control group(asymptomatic infection patients,115 cases)and observation group(mild infection,116 cases)according to the type of symptoms of novel coronavirus,and the clinical characteristics of the two groups were compared.Patients were followed-up for 1 month after the novel coronavirus infection,and the incidence of angina pectoris was compared between the two groups.The Cox regression model was used to analyze independent risk factors for angina pectoris attack.Results Compared to the control group,age of the observation group was older,body mass index,D-Dimer and hemoglobin levels were lower,and the proportion of chronic lung disease was higher(all P<0.05).The risk of angina pectoris in the short term in the observation group was higher than that in the control group(hazard ratio:2.371,95%confidence interval:1.373-4.094,P=0.002).Multivariate Cox regression analysis showed that age(hazard ratio:1.065,95%confidence interval:1.026-1.106,P=0.001),number of coronary lesion branches(hazard ratio:1.777,95%confidence interval:1.297-2.435,P<0.001),and type of novel coronavirus symptoms(hazard ratio:1.813,95%confidence interval:0.986-3.101,P=0.031),haemoglobin level(hazard ratio:0.980,95%confidence interval:0.963-0.997,P=0.024)were short-term independent risk factors for angina pectoris.Conclusions The risk of angina pectoris is higher in CHD patients with mild infection with novel coronavirus than those with asymptomatic infection,and the occurrence of angina pectoris is independently associated with patient age,type of novel coronavirus symptoms,number of coronary lesion branches,and haemoglobin level.