冠状动脉造影患者心血管病危险因素与冠状动脉病变程度的相关性分析

目的探讨心血管疾病危险因素与冠状动脉造影病变程度相关性。方法入选行冠状动脉造影住院病例920例,其中确诊冠心病患728例(占79．13％),排除冠心病患192例(占20．87％)。冠状动脉造影病变程度由病变支数,经造影是否诊断冠心病及病变Gensini总积分表示。危险因素包括性别、年龄、高血压病、吸烟、2型糖尿病、血脂异常、高尿酸。采用单因素和多因素分析。结果(1)单因素分析显示,在病变程度不同的各组间比较,随各组中存在单个危险因素病例百分率的增加,冠状动脉造影病变支数和病变Gensini总积分随之增加。(2)多因素Logistic回归分析(前进法)显示,高LDL-C为冠状动脉造影诊断冠心病最显的独立相关危险因素(OR=2．816,95％可信区间1．903,4．167,P=0．001),其他危险因素依次为男性、吸烟、2型糖尿病、低HDL-C、高血压病、高尿酸血症和增龄。性别分组后分别经多因素Logistic回归(前进法)分析显示,男性组中高LDL-C为冠状动脉造影诊断冠心病最显的独立相关的危险因素(OR=2．965,95％可信区间1．880,4．676,P=0．009)。女性分组中吸烟(OR=2．840,95％可信区间0．553,5．378,P=0．001)和高尿酸血症(OR=2．132,95％可信区间1．048,3．641,P=0．017)为冠状动脉造影诊断冠心病最显的独立相关的危险因素。结论高LDL-c是冠状动脉造影诊断冠心病最显的独立相关危险因素,在男性组中更为突出,但其他危险因素如男性、吸烟、2型糖尿病、低HDL-c、高血压病、高尿酸和增龄亦不可忽视,并且各危险因素在不同性别中危险程度有所不同,应该加以区别对待和重视。

Study of the relationship between cardiovascular risk factors and severity of coronary artery disease in patients underwent coronary angiography

ObjectiveTo evaluate the correlation between multiple cardiovascular risk factors and the extent and severity of angiographic coronary artery disease (CAD) in patients underwent coronary angiography.MethodsNine hundred and twenty consecutive patients underwent coronary angiography were selected according to inclusion criteria. The extent and severity of angiographic CAD was diagnosed by: (1)whether or not CAD was diagnosed by angiography; (2)the number of diseased vessels; (3)The CAD Gensini cumulative index. Cardiovascular risk factors included were age, gender, hypertension, smoking status, type 2 diabetes mellitus, dyslipidemia, and high uric acid level. Analyses were achieved by univariate and multivariate analysis.Results(1) Logistic regression analysis showed that high low-density lipoprotein was a prominent predictor of the extent and severity of angiographic CAD (OR=2.816, 95% CI 1.903-4.167, P= 0.001).(2) High low-density lipoprotein was the most important risk factor in men, whereas smoking and high uric acid were the most important risk factors in women.Conclusion(1) It is very important to control risk factors in the intervention and prevention of CAD. (2) Distribution of risk factors and their severities vary in different genders, therefore the treatment of risk factors should be done differently.