| 早发冠心病患者冠状动脉病变特点及危险因素分析 |
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| 引用本文： | 王欣,夏豪,童随阳,李磊. 早发冠心病患者冠状动脉病变特点及危险因素分析[J]. 中国心血管病研究杂志, 2014, 0(11): 961-964 |
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| 作者姓名： | 王欣 夏豪 童随阳 李磊 |
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| 作者单位： | 武汉大学人民医院心内科,湖北省武汉市430060 |
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| 基金项目： | 2012年国家自然科学基金（项目编号：81270184） |
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| 摘 要： | 目的 探讨早发冠心病患者冠状动脉病变特点及危险因素.方法 入选我院2012年6月至2014年4月经冠状动脉造影诊断为冠心病的患者279例,根据男性年龄≤55岁、女性年龄≤65岁分为早发冠心病组和非早发冠心病组.统计患者入院基本临床资料.所有患者均检测空腹血糖（FPG）、总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL-C）和低密度脂蛋白胆固醇（LDL-C）.根据冠状动脉狭窄直径≥50％累及左前降支（LAD）、左回旋支（LCX）、右冠状动脉（RCA）或左主干（LM）分为单支、双支（累及左主干为双支病变）及三支病变组.根据Gensini积分标准对每位患者冠状动脉病变进行评分.结果 早发冠心病组男性比例、吸烟比例、存在早发冠心病家族史的比例、TG水平显著高于非早发冠心病组（P＜0.05）.与非早发冠心病组相比,早发冠心病组患者以单支病变为主,二者在受累冠状动脉部位上并无差别.非早发冠心病组患者平均冠状动脉病变支数、平均Gensini积分高于早发冠心病组（1.97±0.82比1.66±0.93,P=0.003;8.72±6.21比48.65±8.90,P=0.000）.多因素Logistic回归分析显示,男性（95％CI：2.342～10.420,P=0.000）、吸烟（95％CI：9.468～31.220,P=0.000）、早发冠心病家族史（95％CI：8.120～23.480,P=0.001）、TG（95％CI：1.224～5.465,P=0.001）是早发冠心病患者独立危险因素.结论 早发冠心病患者冠状动脉病变特点是以单支病变为主.男性、吸烟、早发冠心病家族史、TG是早发冠心病患者的独立危险因素.积极戒烟、降低TG能够降低早发冠心病的发病率.
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| 关 键 词： | 冠状动脉疾病 冠状动脉病变 危险因素 胆固醇 |
The analysis of coronary artery lesions and risk factors in patients with premature coronary heart disease |
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| Affiliation: | WANG Xin, XIA Hao, TONG Sui-yang, et al. (Department of Cardiovascular Medicine, Renmin Hospital of Wuhan University, Wuhan 430060, China) |
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| Abstract: | Objective To explore the characteristics of coronary artery lesions and risk factors in prema- ture coronary heart disease （CHD） patients. Methods 279 patients were diagnosed CHD by coronary angiography from June 2012 to Apr 2014 in our hospital. Patients were divided into premature CHD group （122 eases ） or non- premature CHD group（ 157 eases） according to age （male≤55 years old and female≤65 years old）. 279 patients diagnosed of CHD were studied basic clinical characteristics, fasting blood glucose （PFG）, total cholesterol（TC）, triglyeerides （TG）, high density lipoprotein cholesterol （HDL） and low density lipoprotein cholesterol （LDL）. All patients were divided into none vessel lesions, 1 vessel lesions, 2 vessels lesions or large main vessel lesions, 3 vessels lesions groups according to lesions of major vessels ≥50%. We evaluate every patient coronary lesions ac- cording to Gensini score criteria. Results Compared with non-premature CHD group, the patient in premature CHD group was more prevalent in male, smoking, family history premature CHD, and TG （P〈0.05）. In terms of coronary artery lesion characteristics, premature CHD group was prevalent in 1 vessel lesions, while there was no significant difference on lesions and positions, compared with non-premature CHD group, the average coronary artery lesions and Gensini score of every patients in premature CHD group was lower（P〈0.05 ）. Muhiariable Logis- tic regression analysis showed that men （95%CI 2.342-10.420, P=0.000）, smoking （95%CI 9.468-31.220, P= 0.000）, family history of premature coronary heart disease（95%CI 8.120-23.480, P=0.001）, TG（95%CI 1.224- 5.465, P=0.001 ） is independent risk factor for premature CHD patients. Conclusion Male, smoking, family his- tory of premature CHD, TG are independent risk factors for premature CI-ID patients, quit smoking, lower TG can reduce the incidence of premature CHD. |
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| Keywords: | Coronary heart disease Coronary artery lesions Risk factors Cholesterol |
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