心血管危险因素与冠脉病变的临床研究(附312例病例分析)

目的:探讨心血管危险因素与冠脉病变的相关性。方法:对于2005年1月～2008年12月在我院住院的312例行冠脉造影患者,采集心血管危险因素资料,包括性别、年龄、体重指数、吸烟、高血压病、糖尿病、低密度脂蛋白-胆固醇(LDL-C),高密度脂蛋白-胆固醇(HDL-C)、尿酸(UA)、纤维蛋白原(Fg)及血清总胆红素(TBIL)等指标,通过冠脉造影直径目测法判断是否患冠心病,分析心血管危险因素与冠脉病变的关系,采用多因素Logistc回归分析筛选冠心病的危险因素。结果:①冠心病组患者男性比例、平均年龄、LDL-C、TG、体重指数、UA水平均显著高于非冠心病组,HDL-C水平均显著低于非冠心病组,且吸烟、高血压病、糖尿病病例显著多于非冠心病组(P<0.05～<0.001)。②Logistic回归分析显示,LDL-C、吸烟、糖尿病、高血压、体重指数,低HDL-C、高龄入选回归方程(OR=2.933～1.143,P<0.05～<0.001),其中LDL-C为最显著的心血管独立相关因素(OR=2.933,95%可信区间1.956～5.345,P<0.001)。结论:LDL-C水平升高、吸烟、糖尿病、高血压、体重指数上升、HDL-C水平降低、高龄为冠心病显著独立相关因素。

Clinical analysis of cardiovascular risk factors and coronary artery disease in 312 patients

Objective：To investigate the incidence of coronary artery disease（CAD） and cardiovascular risk factors. Methods： The clinical data were gathered in 312 patients undergone coronary angiography （CAG） during Jan. 2005 and Dec. 2008 for evaluating the cardiovascular risk factors concerning sexes, ages, body mass index （BMI）, status of cigarette smoking, history of hypertensive disease and Type 2 diabetes mellitus （ DM ）, concentration of low-density lipoprotein cholesterol （ LDL-C ） , high-density lipoprotein cholesterol （ HDL-C ）, uric aeid （ UA）, fibrinogen（Fg） and serum total bilirubin （TBIL）. Diagnosis of CAD was based on measuring the stenosis of vessels diameter ≥50% and the risk factors were determined by Logistic regression analysis. Results： ①Compared with subjects of non-CAD, the male cases had much higher risk factors for the incidenee regarding the mean age, level of LDL-C and TG, BMI and UA concentration, history, of smoking, hypertension and DM, （ P 〈0.05 〈0. 001 ）.②Logistic regression analysis showed that LDL-C, smoking, Ttype 2-DM, hypertensive disease, BMI, lower HDL-C and aging were the higher risk factors of CAD （ OR = 2. 933 - 1. 143, P 〈 0.05 -〈 0. 001 ） , and LDL-C was prominent among the risk factors （ OR =2. 933, 95% CI. 1. 956 -5. 345 ,P 〈0. 001 ）. Conclusion ：The findings suggest that the risk factors of CAD are independently associated with LDL-C, history of smoking, Type 2-DM, and hypertensive disease, BMI, lower HDL-C level and aging.