早发冠心病的危险因素及冠脉病变特点分析

Analysis of risk factors of early-onset coronary heart disease and the characteristics of coronary lesions

目的探讨早发冠心病危险因素及冠脉病变特点。方法回顾性分析某科2017年8月至2018年1月共386例选择性冠脉造影(coronary arteriongraphy,CAG)患者的临床资料,根据冠脉造影检查结果及发病年龄将其分为非冠心病组(n=101)、早发冠心病组(n=88)及晚发冠心病组(n=197),分析早发和晚发冠心病的临床特点、冠脉造影特点,多因素分析影响早发冠心病的危险因素。结果与非冠心病组相比,早发、晚发冠心病组中男性、吸烟及糖尿病比例高,高密度脂蛋白胆固醇(HDL-C)水平偏低(P<0.05);晚发冠心病组与早发冠心病组相比,合并糖尿病比例偏低(P<0.05);多因素分类Logistic回归分析结果显示,吸烟(OR=2.860,95%CI:1.140～7.175)增加早发冠心病的风险;高龄(OR=1. 172,95%CI:1. 124～1. 222)、男性(OR=3. 276,95%CI:1. 647～6. 516)、吸烟(OR=3.699,95%CI:1.616～8.468)、血糖增高(OR=1.351,95%CI:1.083～1.686)增加晚发冠心病的风险;早发冠心病组和晚发冠心病组在冠脉病变支数和病变部位上差异无统计学意义。结论吸烟及糖尿病增加早发冠心病风险,早发冠心病病变并不轻于晚发冠心病。积极开展针对相关可控危险因素(尤其吸烟)的干预及管理,可延缓冠脉病变进展。

Objective To investigate the risk factors of coronary heart disease and the characteristics of coronary lesions.Me thods The clinical data of 386 patients with selective coronary angiography(CAG)from August 2017 to January 2018 were retrospectively analyzed.According to the results of coronary angiography and age of onset,they were divided into non-crown heart disease group(n=101),early-onset coronary heart disease group(n=88)and late-onset group(n=197).The clinical features of early-onset and late-onset coronary heart disease,coronary angiographic features,multivariate analysis risk factors for coronary heart disease were analyzed.Re s ults Compared with the non-coronary heart disease group,the proportion of men,those who smoked and had diabetes was high in the early-onset and late-onset coronary heart disease group and the high-density lipoprotein level was low(P<0.05).Compared with the early-onset coronary heart disease group,the proportion of diabetes mellitus of the late-onset coronary heart disease group was lower(P<0.05).Multivariate logistic regression analysis showed that smoking(OR=2.860,95%CI:1.140~7.175)increased the risk of early-onset coronary heart disease while the advance of age(OR=1.172,95%CI:1.124~1.222),being male(OR=3.276,95%CI:1.647~6.516),smoking(OR=3.699,95%CI:1.616~8.468)and increased blood glucose(OR=1.351,95%CI:1.083~1.686)increased the risk of late-onset coronary heart disease.There was no significant difference in the number of coronary lesions and lesions between the early-onset coronary heart disease group and the late-onset coronary heart disease group.Conclus ion Smoking and diabetes increased the risk of early-onset coronary heart disease.Early onset coronary heart disease is not less severe than late onset coronary heart disease.Targeted interventions and management on relevant controllable risk factors(especially smoking)can delay the progression of coronary lesions.