不同性别冠心病三支病变患者的危险因素分析

Analysis on the Risk Factors of Triple-vessel Coronary Artery Disease Between Different Genders

目的分析不同性别冠脉三支病变患者的危险因素,讨论多项冠心病危险因素与冠脉三支病变的相关性。方法入选2005~2009年入院行冠状动脉造影术且最终诊断为冠心病的患者1 262例(男性907例,女性355例),分别记录性别、年龄、有无高血压、胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDLC)、高密度脂蛋白胆固醇(HDLC)、尿酸(UA)、有无糖尿病、是否吸烟等指标。首先根据是否为三支病变分为两组,分别对两组之间的危险因素进行分析比较,然后根据性别分成男性组和女性组,分别比较男性组和女性组中三支病变与非三支病变组间的危险因素,最后通过Logistic回归分析法比较三支病变与各项危险因素之间的相关性。结果单因素分析发现冠脉三支病变组的年龄、男性比率、TC、LDLC、UA、高血压比率、糖尿病比率、吸烟比率均高于非三支病变组,HDLC低于非三支病变组,差异有统计学意义(P<0.05);男性三支病变组的年龄、TC、LDLC、UA、糖尿病比率均高于非三支病变组,HDLC低于非三支病变组,差异有统计学意义(P<0.05);女性三支病变组的年龄、LDLC、高血压比率、糖尿病比率均高于非三支病变组,HDLC低于非三支病变组,,差异有统计学意义(P<0.05)。进一步通过多因素Logistic回归分析发现冠状动脉三支病变最显著的独立危险因素是糖尿病。结论年龄的增加、男性、高TC、高LDLC、低HDLC、高UA、高血压、糖尿病、吸烟等危险因素均可以加重冠状动脉病变程度,增加冠状动脉三支病变的发生,其中糖尿病是最为显著的影响因素。其中与男性冠状动脉三支病变有关的危险因素有年龄、高TC、高LDLC、低HDLC、高UA、糖尿病;与女性冠状动脉三支病变有关的危险因素有年龄、高LDLC、低HDLC、高血压、糖尿病。

Aim To analyze the risk factors for triple-vessel coronary artery disease between different genders.Methods A total of 1 262 patients( 907 males and 355 females),who underwent coronary angiography and were diagnosed coronary heart disease,and their gender,ages,hypertension,total cholesterol( TC),triglycerides( TG),low-density lipoprotein cholesterol( LDLC),high-density lipoprotein cholesterol( HDLC),uric acid( UA),diabetes and smoking history were recorded. First,all cases were divided into two groups according to whether triple-vessel disease or not.Risk factors were compared between the two groups. Then they were further divided into groups based on gender,the risk factors between triple-vessel coronary artery disease and non-triple-vessel coronary artery disease in males and females were compared respectively. Results Univariate analysis showed that the age,male ratio,TC,LDLC,UA,hypertension ratio,diabetes ratio,smoking ratio of triple-vessel coronary artery disease were higher than non-triple-vessel coronary artery disease. The HDLC of triple-vessel coronary artery disease was lower than non-triple-vessel coronary artery disease.And the difference was statistically significant( P < 0. 05). For males,the age,TC,LDLC,UA,diabetes ratio of triplevessel coronary artery disease were higher than non-triple-vessel coronary artery disease. The HDLC of triple-vessel coronary artery disease was lower than non-triple-vessel coronary artery disease. And the difference was statistically significant( P < 0. 05). For female,the age,LDLC,hypertension ratio,diabetes ratio of triple-vessel coronary artery disease were higher than non-triple-vessel coronary artery disease. The HDL-C of triple-vessel coronary artery disease was lower than non-triple-vessel coronary artery disease. And the difference was statistically significant( P < 0. 05). Logistic regression analysis showed that the most significant risk factor for triple-vessel coronary artery disease were diabetes. Conclusion The increase of age,male,high TC,high LDLC,low HDLC,high UA,diabetes,hypertension,smoking are risk factors to increase the severity of coronary heart disease,and increase the triple vessel disease,among which diabetes is the most significant risk factors. The increase of age,high TC,high LDLC,low HDLC,high UA,diabetes are risk factors to increase the triple vessel disease of males; and the increase of age,high LDLC,low HDLC,diabetes,hypertension are risk factors to increase females the triple vessel disease of females.