冠心病患者合并下肢动脉狭窄危险因素分析

目的探讨冠心病患者合并下肢动脉狭窄的危险因素。方法选取2009年6月～2012年6月在第二炮兵总医院心血管内科确诊冠心病患者1421例，均行下肢动脉CT血管成像（CTA）；根据CTA结果，将至少1处病变血管直径狭窄率≥70％定为狭窄组（n=626），其余为对照组（n=795）。比较两组患者的临床特征。采用二分类变量Logistic回归筛选冠心病患者发生下肢动脉狭窄的危险因素。结果冠心病患者中下肢动脉狭窄的发病率为44．05％（626／1421）。两组性别、收缩压、三酰甘油、心肌梗死病史差异有统计学意义（P〈0．05），两组年龄、吸烟史、饮酒史比较，差异无统计学意义（P〉0．05）。二分类Logistic回归显示，性别（OR=1．337。95％CI1．039～1．721，P=0．024）、收缩压（OR=1．014，95％CI1．009～1．020，P=0．000）、三酰甘油（OR：1．190，95％CI1．055～1．341，P：0．005）、心肌梗死病史（OR=1．463，95％CI1．088～1．966，P=0．012）均为冠心病合并下肢动脉狭窄发病的独立危险因素。结论冠心病合并下肢动脉狭窄发病与多种独立危险因素有关．采取相应措施可降低冠心病患者合并下肢动脉狭窄发病率。

Analysis of the risk factors of patients with coronary artery disease com- plicated with lower limb artery stenosis

Objective To investigate the risk factors of patients with coronary artery disease complicated with lower limb artery stenosis. Methods 1421 patients with confirmed coronary heart disease from June 2009 to June 2012 in General Hospital of the Second Artillery were selected, all the patients were treated with underwent CT angiography （CTA）. The patients were divided into stenosis group （n = 626, blood vessel diameter stenosis rate I〉70% at least 1 of blood vessel） and control group （n = 795）. The clinical features in the two groups were analyzed and the risk factors associated with coronary artery disease complicated with lower limb artery stenosis were explored by Logistic regression analysis. Results The incidence of lower limb artery stenosis in patients with coronary artery disease was 44.05% （626/1421）. The differences of gender, systolic pressure, triacylglycerol, history of myocardial infarction in the two groups were statistically significant （P 〈 0.05）; the differences of age, history of smoking, history of alcohol in the two groups were not statistically significant （P 〉 0.05）. Gender （OR = 1.337,95%CI：1.039-1.721 ,P = 0.024）, systolic pressure （OR = 1.~014,95%Ch 1.009-1.020, P = 0.000）, triacylglycerol （OR = 1.190,95% Ch 1.055-1.341, P = 0.005）, history of myocardial infarction （OR = 1.463,95%CI： 1.088-1.966 ,P = 0.012） were the risk factors associated with coronary artery disease complicated with lower limb artery stenosis according to the Logistic regression analysis. Con- clusion Coronary artery disease complicated with lower limb artery stenosis has relationship with variety of independent risk factors, it is right to take corresponding measures to reduce the morbidity of coronary artery disease compli- cated with lower limb artery stenosis.