中国人和澳大利亚人冠状动脉病变对比研究

目的探讨中国人和澳大利亚人冠状动脉病变的差异。方法中国南京和澳大利亚悉尼3个中心同步注册人选临床可疑冠心病行冠状动脉造影病例6251例（黄种人3021例,白种人3230例）,其中黄种人确诊冠心病患者2098例（占69．4％）,白种人确诊冠心病患者2439例（占75．5％）。冠状动脉病变程度由病变部位、支数及病变Gensini总积分表示。结果（1）两组冠状动脉病变主要累及血管均依次为左前降支、右冠状动脉、左回旋支和左主干。（2）黄种人和白种人男性三支病变分别为29．8％和34．0％,女性为15．8％和26．2％,男性左主干病变分别为9．6％和14．2％,女性为4．9％和11．6％,两组男性三支病变及左主干病变均高于女性,单支病变低于女性（P〈0．01）,双支病变不同性别间均无统计学差异（P〉0．05）。（3）白种人三支病变及左主干病变为31．9％和13．5％,高于黄种人（分别为26．0％和8．3％,均P〈0．01）,单支病变低于黄种人（38．0％比44．7％,P〈0．01）,双支病变两组间差异无统计学意义（30．1％比29．3％,P〉0．05）。Gensini总积分随年龄增长而增加。40岁以上相同年龄段,白种人Gensini总积分均明显高于黄种人。结论冠状动脉病变随年龄增加而增加,男性冠状动脉病变严重程度较相同年龄段女性重。澳大利亚人冠心病患者冠状动脉病变严重程度均较中国人同性别重。提示同样程度冠状动脉粥样硬化,澳大利亚人比中国人早10余年。

Coronary artery lesion comparison between Chinese and Australian patients with coronary artery disease

OBJECTIVE: To compare coronary lesion characteristics by coronary angiography (CAG) between yellows and whites. METHODS: CAG results of 3021 Chinese patients, defined as yellows, from Nanjing and 3230 Australian patients, defined as whites, from Sydney were analyzed. The coronary artery lesion was evaluated by the number and location of coronary lesion and Gensini scores. RESULTS: (1) Coronary stenosis was diagnosed in 69.4% Chinese patients and 75.5% in Australians. The involved coronary arteries were left anterior descending branch, right coronary artery, left circumflex branch and left main coronary artery in a descending order in both Chinese and Australians. (2) The incidences of three-vessel disease and left main disease of yellows were significantly lower than that of whites in both male (29.8% vs. 34.0% and 9.6% vs. 14.2%) and female patients (15.8% vs. 26.2% and 4.9% vs. 11.6%) respectively, all P < 0.05. (3) There was an age-dependent Gensini scores increase in both yellows and whites patients and Gensini scores at age 40 and more of whites were significantly higher than those of yellows in comparable age groups. CONCLUSION: The incidences of three-vessel disease and left main disease as well as Gensini score were significantly higher in Australian patients than those of Chinese patients.