江苏地区不同类型冠心病患者发病及预后的多危险因素Logistic分析

目的：通过对江苏地区不同类型冠心病发病及预后的危险因素进行回顾性分析，以期对冠心病防治起到积极作用。方法：回顾性分析2016~2019 年江苏省3所三甲医院、经冠状动脉造影确诊为冠心病20580例，按患病原因分冠心病组、非冠心病组。收集各组患者性别、年龄、体重指数、烟酒史；脑血管、心源性疾病和发病至入院时间等相关资料，单因素分析筛选4种不同类型冠心病发病危险因素，行多因素Logistic回归分析动脉粥样硬化与4种类型冠心病发病的关系；同时回归分析因不良心血管事件（MACE）等预后症状收治并接受冠状动脉造影的不同类型冠心病患者预后危险因素。结果： 性别、年龄、吸烟为不同类型冠心病发病组共同独立危险因素。4种类型冠心病独立危险因素不完全相同，性别、年龄、高血压为AP独立危险因素；性别、年龄、糖尿病、hs-CRP为UAP独立危险因素；性别、年龄、糖尿病、HDL-C、空腹血糖、hs-CRP为STEMI及NSTEMI独立危险因素（P<0.05）。预后风险回归分析结果显示，年龄、糖尿病史、心源性休克、心律失常、心力衰竭和发病至入院时间是4种类型冠心病病患者发生MACE预后独立危险因素（P<0.05）。结论：不同冠心病发病危险因素主要有年龄、高血压、糖尿病病史、吸烟史，且在年龄与高血压、年龄与糖尿病、高血压和吸烟之间存在冠心病发生的正交互作用。预后的独立危险因素主要包括年龄、糖尿病史、心源性休克、心律失常、心力衰竭和发病至入院时间。

Multivariate Logistic Analysis of Risk Factors for the Onset and Prognosis of Patients with Different Types of Coronary Heart Disease in Jiangsu Province

To retrospectively analyze the risk factors for the onset and prognosis of different types of coronary heart disease in Jiangsu Province. Methods: A retrospective study was done on 22680 patients who had received coronary angiography in the departments of cardiology of three first-class hospitals in Jiangsu Province from 2016 to 2019, and 20580 cases of coronary heart disease were confirmed, all were divided into different groups according to their etiology. Data were collected regarding sex, age, body mass index, drinking and smoking history, cerebrovascular disease, cardiogenic shock and the time from onset to admission, etc. Univariate analysis was performed to screen the risk factors of four different clinical types of coronary heart disease, and multivariate logistic regression was conducted to investigate the relationship between atherosclerosis and the development of four types of coronary heart disease. Simultaneously, the prognostic risk factors of different types of coronary heart disease treated with coronary angiography due to adverse cardiovascular events (MACE) and other prognostic symptoms were analyzed by regression analysis. Results: The results of logistic regression analysis showed that gender, age and smoking were the common independent risk factors of different types of coronary heart disease. In addition, the four types of coronary heart disease had different independent risk factors: gender, age, and hypertension for AP; gender, age, diabetes, and hs-CRP for UAP; as well as sex, age, diabetes, HDL-C, fasting blood glucose, and hs-CRP for STEMI and NSTEMI (P<0.05). The regression analysis of prognostic risk factors showed that age, history of diabetes, cardiogenic shock, arrhythmia, heart failure and the time from onset to admission were independent prognostic MACE risk factors in patients with 4 types of coronary heart disease (P<0.05). Conclusion: The risk factors of different types of coronary heart disease in Jiangsu Province mainly include age, history of hypertension, history of diabetes and smoking, and there are orthogonal effects between age and hypertension, age and diabetes, and hypertension and smoking. Independent risk factors for prognosis mainly include age, history of diabetes, cardiogenic shock, arrhythmia, heart failure and time from onset to admission. Our study can play a positive role in the prevention and treatment of coronary heart disease.