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陈君,郭志刚,胡威,修建成,周忠江.男性早发冠心病冠状动脉病变特点和危险因素的研究[J].陆军军医大学学报(原第三军医大学学报),2009,31(11):1091-1094.
CHEN Jun,GUO Zhi-gang,HU Wei,XIU Jian-cheng,ZHOU Zhong-jiang.Cardiovascular risk factors and coronary features of male patients with premature coronary artery disease[J].J Amry Med Univ (J Third Mil Med Univ),2009,31(11):1091-1094.
陈君,郭志刚,胡威,修建成,周忠江.男性早发冠心病冠状动脉病变特点和危险因素的研究[J].陆军军医大学学报(原第三军医大学学报),2009,31(11):1091-1094. DOI:
CHEN Jun,GUO Zhi-gang,HU Wei,XIU Jian-cheng,ZHOU Zhong-jiang.Cardiovascular risk factors and coronary features of male patients with premature coronary artery disease[J].J Amry Med Univ (J Third Mil Med Univ),2009,31(11):1091-1094. DOI:
目的 对男性早发冠心病患者心血管疾病危险因素及冠状动脉造影病变特点进行研究。 方法 448例经冠状动脉造影确诊为冠心病的男性患者,按年龄分为早发组145例(<55岁)和晚发组(≥55岁)303例,对2组患者的危险因素及冠状动脉病变特点进行统计学比较,并应用多因素分析筛选男性早发冠心病的独立危险因素。冠状动脉造影病变程度由病变支数及病变Gensini总积分表示。危险因素包括高血压病、2型糖尿病、高脂血症、吸烟史、血红蛋白、总胆红素、血尿酸、血浆纤维蛋白原及缺血性心血管病家族史。 结果 危险因素分析显示,男性早发组缺血性心血管病家族史的比例,血浆总胆固醇、血浆甘油三酯、血红蛋白、血浆纤维蛋白原水平及吸烟史显著高于晚发组(P0.01
P0.05)。冠状动脉造影结果显示
早发组患者在单支血管病变所占比例显著高于晚发组(P0.01);而早发组患者在左回旋支冠状动脉和右冠状动脉血管病变所占比例及Gensini总积分中第4组所占比例显著低于晚发组(P0.01
P0.05)。 结论 缺血性心血管病家族史、吸烟、高甘油三酯血症、血浆纤维蛋白原、血红蛋白是男性早发冠心病患者的独立危险因素。男性早发患者冠脉病变较轻。预防冠心病应从尽早积极控制心血管病危险因素开始,改变不良生活方式,并加强对有血液高凝状态患者的重视。
Objective To explore the cardiovascular risk factors and clinical features of coronary lesions in male patients with premature coronary artery disease (CAD). Methods A total of 448 male patients with CAD confirmed by angiography were divided into two groups by age: premature CAD (n=145
55 y) and mature CAD (n=303
≥55 y). The risk factors of premature CAD and the clinical features of coronary lesions were compared statistically. The independent risk factors in premature CAD were screened by multi-factor analysis. The extent and severity of angiographic CAD were diagnosed by the number of narrowed vessels and the CAD Gensini cumulative index. Cardiovascular risk factors included hypertension
smoking
type 2 diabetes mellitus
hemoglobin
total bilirubin
plasma lipid
plasma uric acid
plasma fibrinogen
and family history of ischemic cardiovascular disease. Results The percentage of family history of ischemic cardiovascular disease
the history of smoking
the level of total cholesterol (TC)
triglyceride (TG)
hemoglobin (HGB) and plasma fibrinogen (Fig) in premature CAD group were higher than those in mature CAD (P0.01
P0.05). The proportion of lesion in the single coronary artery in premature CAD group was higher than that in mature CAD (P0.01). The proportion of lesions in the left circumflex branch (LCX) and the right coronary artery (RCA) and the CAD Gensini cumulative index in premature CAD were lower than those in mature CAD (P0.01
P0.05). Conclusion Family history of ischemic cardiovascular disease
history of smoking
and levels of TG
HGB
and Fig may be the independent risk factors in premature CAD. Higher proportion of single vessel lesion and slight lesion can be found in premature CAD patients than that in mature CAD patients.
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