冠心病危险因素分析及其与冠状动脉狭窄程度的关系

摘要

目的 分析冠状动脉粥样硬化性心脏病(冠心病)患病的相关危险因素及其与冠状动脉(冠脉)狭窄严重程度的关系.方法 回顾性分析2013年10月～2015年10月于新疆维吾尔自治区中医医院行冠脉造影的疑似冠心病患者185例临床资料,其中男性125例,女性60例,年龄范围29～78岁,平均(60.35±10.04)岁.入选者首次行冠脉造影,根据造影结果分为冠心病组(129例)与非冠心病组(56例).收集患者性别、年龄、高血压、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、糖尿病及吸烟史等资料.冠脉病变狭窄严重程度采用Gensini积分进行评价.结果 与非冠心病组比较,冠心病组中男性、高血压、肥胖、高LDL-C、低HDL-C、糖尿病及吸烟史的比例升高,年龄增加,差异有统计学意义(P均<0.05).年龄(OR=1.876,95％CI:1.452～2.345)、性别(OR=1.755,95％CI:1.430～2.486)、肥胖(OR=1.268,95％CI:1.011～1.567)、高LDL-C(OR=1.928,95％CI:1.478～2.559)、低HDL-C(OR=1.378,95％CI:1.045～1.981)、糖尿病(OR=2.345,95％CI:1.526～3.677)以及吸烟史(OR=2.239,95％CI:1.460～3.329)均为冠心病患病的独立危险因素.不同年龄、性别以及有无高血压、肥胖、高LDL-C、低HDL-C、糖尿病、吸烟史冠心病患者的Gensini评分比较,差异有统计学意义(P均<0.05).结论 男性、肥胖、高血脂、糖尿病及吸烟史为冠心病的危险因素,且合并上述危险因素的冠心病患者冠状动脉狭窄更严重,应予以重视.%Objective To analyze the relationship between risk factors related to coronary heart disease (CHD) and coronary stenosis severity.Methods The clinical materials were retrospectively analyzed in patients (n=185, male 125, female 60, aged from 29 to 78 and average age=60.35±10.04) with suspected CHD in the Xinjiang Hospital of Traditional Chinese Medicine from Oct. 2013 to Oct. 2015. All patients were received coronary angiography (CAG) for the first time, and according the results they were divided into CHD group (n=129) and non-CHD group (n=56). The data of sex, age, hypertension, low-density lipoprotein-cholesterol (LDL-C), high-density lipoprotein-cholesterol (HDL-C), diabetes and smoking was collected. The coronary stenosis severity was reviewed by using Gensini scoring.Results Compared with non-CHD group, the proportion of male patients, and patients with hypertension, obesity, higher LDL-C, lower HDL-C, diabetes, smoking history and higher age increased in CHD group (allP<0.05). Age (OR=1.876,95％CI:1.452～2.345), sex (OR=1.755,95％CI:1.430～2.486), obesity (OR=1.268,95％CI:1.011～1.567), higher LDL-C (OR=1.928,95％CI:1.478～2.559), lower HDL-C (OR=1.378,95％CI:1.045～1.981), diabetes (OR=2.345,95％CI:1.526～3.677) and smoking history (OR=2.239,95％CI:1.460～3.329) all were independent risk factors of CHD. The comparison in Gensini scores showed statistical difference among patients with different ages and sex, and with whether or not hypertension, obesity, higher LDL-C, lower HDL-C, diabetes and smoking history (allP<0.05).Conclusion Male, obesity, higher blood fat, diabetes and smoking history are risk factors of CHD, and coronary stenosis will be more severe in CHD patients with these risk factors.