高血压病患者的冠心病危险因素分析

目的　探讨高血压患者发生冠心病的危险因素。方法　 15 9例中男 89例 ,女 70例 ,平均年龄 (5 9.6± 9.2 3)岁 ,有典型心绞痛或不典型胸痛的高血压病患者以性别、年龄、体重指数 (BMI)、坐位舒张压、空腹血糖、总胆固醇 (TC)、甘油三酯 (TG)、高密度脂蛋白 (HDL C)、低密度脂蛋白 (LDL C)、纤维蛋白原、吸烟量、冠心病家族史等多种危险因素及冠状动脉狭窄程度评分 (冠脉评分 )进行多变量分析 ,患者均行冠脉造影 ,84例冠状动脉造影狭窄≥ 5 0 % ,诊断为冠心病。结果　多元逐步回归及多元lo gistic回归分析显示 :纤维蛋白原、空腹血糖、舒张压、吸烟等级与冠心病独立相关 ,冠心病的相对危险率(OR)分别为 :纤维蛋白原 >5g L为≤ 5g L的 4 .36 2倍 ;空腹血糖 >6 .1mmol L为≤ 6 .1mmol L 7.6 5 4倍 ;舒张压≥ 90mmHg为 <90mmHg的 2 .6 77倍 ;吸烟级别 =3级为 <3级的 6 .5 0 2倍。回归分析结果显示纤维蛋白原、空腹血糖、舒张压、吸烟等级与冠心病独立相关 ,纤维蛋白原、总胆固醇与冠脉狭窄评分独立相关。结论　高血压病患者的纤维蛋白原、空腹血糖、吸烟等级、舒张压与冠心病独立相关 ,纤维蛋白原、总胆固醇与冠脉病变程度有关

The analysis for risk factors of coronary heart disease

Objective To determine the risk factors of coronary heart disease in essential hypertension.Methods Coronary angiography was performed in 159 essential hypertension patients (89 men and 70women;59.6±9.23 years of age)accompanying either angina pectoris or atypical chest pain,coronary artery stenosis of greater than 50% was defined as coronary heart disease (CHD).Treatment of aspirin,lipid lowering agents,heparin and those with renal,hepatic,or thyroid diseases were excluded before blood sampling.Gender,age,body mass index,fasting plasma glucose,total cholesterol,triglyceride,high density lipoprotein cholesterol,low density lipoprotein cholesterol,fibrinogen,cigarette smoking consuming,CHD family history and cornary artery stenosis severity (CASS) were analysed.Results Stepwise multiple regression and multiple logistic regression analysis showed:fasting plasma glucose,fibrinogen,seated diastolic pressure and cigarette smoking consuming were significantly independent association with CHD.Odds ratio of CHD for fibrinogen,fasting plasma glucose,seated diastolic pressure,cigarette smoking was 4.362 (above 5 g/L vs equal or less than 5 g/L,P< 0.05 ),7.654 (above 6.1 mmol/L vs equal or less than 6.1 mmol/L,P< 0.05 ),2.677 (above or equal 90 mmHg vs less than 90 mmHg,P< 0.05 ),6.502 (above 3 grade vs equal or less than 2 grade,P<0.05) respectively.In stepwise multiple regression analysis,total cholesterol and fibrinogen showed significant independently associates with CASS.Conclusion Fasting plasma glucose,fibrinogen,seated diastolic pressure and cigarette smoking independently associate with CHD in essential hypertension patients and fibrinogen,total cholesterol independetly associate with CASS.