代谢综合征与冠心病患者预后的关系

目的 探讨代谢综合征(MS)及其单一因素(肥胖,糖代谢异常,血脂紊乱,高血压)对冠心病患者预后的影响.方法 对接受血运重建治疗的冠心病患者215例检测代谢综合征各指标,观察主要不良心血管事件(MACCE)发生情况,采用Logistic回归分析法分析代谢综合征各因素对冠心病患者预后的影响.结果 随访1～3年半,平均2年7个月,51例发生MACCE(其中25例患有MS,占49.02%),164例未发生MACCE(其中50例患有MS,占30.49%).MACCE组和非MACCE组血糖、收缩压、舒张压、TC、TG、LDL-C、HDL-C、BMI等指标差异均无统计学意义(P>0.05).应用Logistic回归模型,未发现糖代谢异常、高血压、TG、HDL-C、BMI任何单一指标对MACCE的发生有统计学意义(P>0.05),但将MS作为一项危险因素进入Logistic回归模型,显示MS对MACCE的发生有预测作用(OR=1.891,95%CI 1.036～3.532,P=0.041).结论 在冠心病血运重建患者中,MS可以预测冠心病患者的不良预后,但各单一因素对冠心病患者的预后缺乏预测作用.

Effect of metabolic syndrome (MS) and its components on the risk of developing coronary artery disease

Objective To evaluate the effect of metabolic syndrome （MS） and its components on the risk of developing coronary artery disease（CAD）. Methods 215 patients from the lth People Hospital of Taizhou between May 2007 and October 2008 join to the clinical try. We recorded the basic document, MS and its components. The patients who suffered major adverse cardiac and cerebral events （MACCE） in the followed period were named the MACCE group, otherwise, were named as the compared group. We compared MS and its components in the two groups, and Logistic Regression Analysis was used to know the effect of MS on prognosis in the patients with CAD. Results （ 1 ） There were 25 patients suffered MS of the 51 MACCE patients, about 49.02% ; （2） There＇ s no significant difference of LDL cholesterol, HDL cholesterol, body mass index, hypertension and glycerin trilaurate in the two group（P 〉 0. 05） ; （3）The presence of MAC CE was predicted only by MS （P = 0. 041, OR = 1. 891, 95% CI 1. 036 -3. 532） but not other cardiovascular risk factors, such as high LDL cholesterol, low HDL cholesterol, obesity, hypertension and high glycerin trilaurate. Conclusion MS has a primary predictive ability for MACCE in CAD patients.