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1. 重庆医科大学附属第二医院心血管内科
2. 重庆医科大学附属第二医院病案统计科,重庆,400010
纸质出版日期:2012,
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郭东梅, 胡蓉, 赵郑波, 等. 重庆地区冠心病危险因素分析[J]. 重庆医科大学学报, 2012,37(4):350-354.
GUO Dongmei, HU Rong, ZHAO Zhengbo, et al. Analysis on risk factors for coronary heart disease in Chongqing area[J]. Journal of Chongqing Medical University, 2012,37(4):350-354.
目的:探讨重庆地区冠心病(Coronary heart disease
CHD)危险因素。方法:收集我院2008年10月 2011年4月行冠状动脉造影病例1 834例,其中确诊CHD 1 169例,排除CHD 665例。分析比较各组间各危险因素的百分比、水平和比率。采用多因素Logistic回归分析方法筛选CHD相关因素。结果:1.CHD组的男性、有CHD家族史、糖尿病、高血压病、吸烟、高尿酸血症及高纤维蛋白原血症等指标比例均明显高于非CHD组(均为P<0.01)。CHD组年龄、收缩压、脉压、高血压病程、白细胞计数、载脂蛋白B、血肌酐、尿素氮、血尿酸、血浆纤维蛋白原、空腹指血血糖、餐后2 h指血血糖等指标水平均明显高于非CHD组(均为P<0.01)。CHD组总胆固醇/高密度脂蛋白胆固醇
甘油三酯/高密度脂蛋白胆固醇
低密度脂蛋白胆固醇/高密度脂蛋白胆固醇
载脂蛋白B/载脂蛋白AI等指标比值均明显高于非CHD组(均为P<0.01)。CHD组高密度脂蛋白胆固醇和载脂蛋白AI水平均明显低于非CHD组(均为P<0.01)。两组间肥胖、舒张压、甘油三酯、总胆固醇、低密度脂蛋白胆固醇等指标差异无统计学意义(均为P>0.05)。2.多因素Logistic回归分析表明男性、CHD家族史、糖尿病、高血压、吸烟、高纤维蛋白原血症、年龄、白细胞计数、载脂蛋白B均与CHD呈显著正相关(β值分别为0.496、1.149、0.595、0.592、0.953、0.282、0050、0.155、1.488,均为P<0.01),高密度脂蛋白胆固醇与CHD呈显著负相关(β值为-0.575,P<0.05)。结论:1.男性、CHD家族史、糖尿病、高血压、吸烟、高纤维蛋白原血症、年龄、白细胞计数、载脂蛋白B与本地区CHD呈正相关,高密度脂蛋白胆固醇与本地区CHD呈负相关。2.降低载脂蛋白B水平、升高高密度脂蛋白胆固醇水平,控制糖尿病及高血压和戒烟等措施可以降低本地区CHD发病率及改善CHD预后。
Objective:To explore the risk factors for coronary heart disease in Chongqing area.Methods:A total of 1 834 consecutive patients who had been diagnosed as coronary heart disease(CHD)(n=1 169) or non-CHD(n=665)by coronary angiography between October 2008 and April 2011 were studied retrospectively.The percentage
level and ratio of each risk factor were analyzed and compared
the correlative factors of CHD were screened by multi-factor logistic regression analysis.Results:1.The percentages of male
family history of CHD
diabetes mellitus(DM)
hypertension
smoking
hyperuricemia and hyperfibrinogenemia were significantly higher in CHD group than those in non-CHD group(all P<0.01).The levels of age
systolic blood pressure(SBP)
pulse pressure(PP)
hypertension duration
WBC count
apolipoprotein B(apoB)
serum creatinine(Scr)
blood urea nitrogen(BUN)
serum uric acid(SUA)
plasma fibrinogen(FIB)
fasting capillary whole blood glucose
and 2-hour postprandial capillary blood glucose were significantly higher in CHD group than those in non-CHD group(all P<0.01).The levels of high density lipoprotein cholesterol(HDL-C) and apolipoprotein AI(apoAI)were significantly lower in CHD group compared with those in non-CHD group(all P<0.01).The ratios of TC/HDL-C
TG/HDL-C
LDL-C/HDL-C
apoB/apoAI were significantly higher in CHD group than those in non CHD group(all P<0.01).There were no significantly differences in obesity
diastolic blood pressure(DBP)
triglyceride(TG)
total cholesterol(TC)
or low-density lipoprotein cholesterol(LDL-C)between the two groups(P>0.05).2.The multi-factor Logistic regression analysis showed that all the parameters of male
family history of CHD
DM
hypertension
smoking
hyperfibrinogenemia
age
WBC count and apoB were significantly positively correlated with CHD(β=0.496
1.149
0.595
0.592
0.953
0.282
0.050
0.155 and 1.488
respectively,all P<0.01)
and HDL-C was significantly negatively correlated with CHD(β=-0.575
P<0.05).Conclusion:1.Male
family history of CHD
diabetes mellitus
hypertension
smoking
hyperfibrinogenemia
age
WBC count
and apoB are significantly positively correlated with CHD in Chongqing area; HDL-C is significantly negatively correlated with CHD.They play an important role in occurrence and progression of coronary heart disease.2.Reducing the level of apoB
increasing the level of HDL-C
controlling DM and hypertension and quitting smoking may be the effective measures to reduce the morbidity and to improve the prognosis of CHD in this area.
冠心病冠状动脉造影危险因素
coronary heart diseasecoronary artery angiographyrisk factor
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