冠心病合并代谢综合征患者的冠状动脉病变特点及与代谢综合征组分的相关性研究

摘要

目的:探讨冠心病合并代谢综合征(metabolic syndrome,MS)患者的冠脉病变特点及冠心病与MS各组分的相关性.方法:选取540例冠心病患者为研究对象,其中合并MS患者164例,非合并MS患者376例,并将所有患者根据MS的组分个数进行分组,比较冠心病合并MS的病变特点、MS组分个数对冠状动脉病变程度的影响及冠状动脉病变程度与代谢综合症各组分的相关性；结果:①冠心病合并MS组BMI、FBG、TG、LDL-C、TC、UA、FIB、高血压分级等指标较非MS组高,差异有统计学意义(P＜0.01),HDL-C、LVEF较非MS组低,差异有显著性(P＜0.01)；②MS组冠脉Gensini积分较高,三支病变、主干病变发生率高,差异有显著性(P＜0.01)；③随着合并MS组分个数的增加,冠脉Gensini积分也逐渐增加,各组间比较有显著性差异(P＜0.01)；④冠脉Gensini积分与MS组分BMI、高血压分级、TG、TC、LDL-C、UA等指标存在正相关(P＜0.05),与性别、HDL-C存在负相关(p＜0.01)；调整传统危险因素后,Gensini积分与MS的组分数显著相关(r=0.739、P＜0.01).结论:冠心病患者有较高的MS患病率,冠心病合并MS患者冠脉病变程度更重,且以多支病变、主干病变为主；随着合并MS组分个数的增加,冠脉病变程度也呈加重趋势；MS的各个组分均与冠状动脉病变程度显著相关,可以作为冠心病严重程度的预测指标.%Objective:To investigate the characteristics of CHD in patients accompanied by metabolic syndrome(MS) and to study the relationship between the severity of coronary atherosclerosis and the components of MS.Methods:540 cases of coronary heart disease patients were chosen,of which 164 cases were combined with MS,376 cases were not combined with MS.All patients were divided into five groups,based on the number of components of MS; and also be divided into two groups,according to the diagnostic criteria for MS.The extent of coronary artery lesions and other indicators in CHD patients between different groups were compared,and the relationships between the degree of CHD and ingredients of MS was explored.Results:①The indicators of BMI,FBG,TG,LDL-C,TC,UA,FIB,high blood pressure levels were higher in patients of MS group than that in non-MS group,while the HDL-c,LVEF were lower in MS group,the differences were significant (P＜0.01).② The patients accompanied by MS had higher gensini score and higher incidence of trunk lesions and triple-vessel lesions,lower incidence of single-vessel lesions,the differences were significant (P＜0.01).③Coronary Gensini score gradually increased,with the combined increasing in the number of MS ingredients,the differences between five groups were significant (P＜0.01).④ Coronary Gensini score had positive correlation with the BMI,Blood pressure levels,TG,TC,LDL-C,UA (P＜0.05).while it had negative correlation with gender,HDL-c.Adjustment for traditional risk factors,and the relationship between Gensini score and the number of MS ingredients was significant(r =0.739,P＜0.01).Conclusion:Coronary heart disease patients had a higher prevalence of MS,when accompanied by MS.The extent of CHD was more severe,mostly triple-vessel lesion and trunk lesion; With the combined increase in the number of MS ingredients,the degree of CHD tendED to be worse; The components of MS were significantly related to CHD,can be used as predictors of the severity of coronary heart disease.