天津医药

天津医药 ›› 2021, Vol. 49 ›› Issue (4): 396-400.doi: 10.11958/20202917

• 临床研究 • 上一篇    下一篇

吸烟与≤45岁男性早发心肌梗死患者冠状动脉病变程度的关系#br#

杨亚男1，高静2，3，李晓卫4，马静3，肖健勇4，高明东4，刘寅2，4△   

  1. 1天津医科大学（邮编300070）；2天津医科大学胸科临床学院；3天津市胸科医院心血管病研究所；4天津市胸科医院心内科
  • 收稿日期:2020-10-22 修回日期:2020-12-07 出版日期:2021-04-15 发布日期:2021-04-16
  • 通讯作者: 刘寅 E-mail:liuyin2088@163.com
  • 作者简介:杨亚男（1987），女，硕士在读，主治医师，主要从事心血管病研究。E-mail：yangyanan2019@126.com
  • 基金资助:
    天津市重点研发计划科技支撑重点项目（20YFZCSY00820）；天津市科技重大专项与工程项目（16ZXMJSY00150）；国家科技部“十三五”重点研发计划重大慢性疾病防控研究重点专项项目（2016YFC1301203）

The relationship between smoking and the severity of coronary lesions in male patients≤45 years old with premature myocardial infarction

YANG Ya-nan1, GAO Jing2, 3, LI Xiao-wei4, MA Jing3, XIAO Jian-yong4, GAO Ming-dong4, LIU Yin2, 4△   

  1. 1 Tianjin Medical University, Tianjin 300070,China; 2 Thoracic Clinical College, Tianjin Medical University;  
    3 Cardiovascular Institute, Tianjin Chest Hospital; 4 Department of Cardiology, Tianjin Chest Hospital
  • Received:2020-10-22 Revised:2020-12-07 Published:2021-04-15 Online:2021-04-16
  • Contact: LIU Yin E-mail:liuyin2088@163.com

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摘要： 目的　探讨吸烟与≤45岁男性早发心肌梗死（PMI）患者冠状动脉病变严重程度的关系。方法　连续纳入经冠状动脉造影，首次诊断为急性心肌梗死（AMI）且≤45岁的男性患者283例。依据吸烟状态分为吸烟组与不吸烟组。比较2组临床基线资料，采用二分类Logistic回归模型分析吸烟与SYNTAX评分及冠状动脉狭窄程度的关系。结果　283例中吸烟患者232例（82.0%）。吸烟组白细胞计数（WBC）、三酰甘油（TG）、极低密度脂蛋白胆固醇（VLDL-C）及脂蛋白（a）水平高于不吸烟组（P＜0.05）；吸烟组患者SYNTAX评分显著高于不吸烟组（P＜0.05）；在冠状动脉单支血管病变和多支血管病变患者中，吸烟组存在重度狭窄病变的比例均高于不吸烟组（P＜0.05）。Logistic回归分析显示，调整混杂因素后，吸烟患者SYNTAX评分≥23分（OR=3.000，95%CI：1.152~7.811）和冠状动脉多支血管重度狭窄（OR=2.275，95%CI：1.098~4.713）的风险较高。结论　吸烟与≤45岁男性PMI患者冠状动脉病变严重程度有关，明显增加冠状动脉SYNTAX高评分和多支血管重度狭窄的风险。

关键词: 吸烟, 男（雄）性, 冠状血管造影术, 心肌梗死, 冠状动脉狭窄, 早发心肌梗死, SYNTAX评分

Abstract: Objective　To explore the relationship between smoking and the severity of coronary lesions in male patients ≤45 years old with premature myocardial infarction (PMI). Methods　Two hundred and eighty three male patients ≤45 years old with initial acute myocardial infarction (AMI) and underwent coronary angiography were included in the study. Patients were divided into two groups according to smoking status. The clinical baseline data were compared between the two groups, and binary Logistic regression model was used to analyze the correlation between smoking and SYNTAX score and the severity of coronary lesions. Results　A total of 283 cases were enrolled, and 232 patients (82.0%) were smokers. The leukocyte count, triglyceride (TG), very low density lipoprotein cholesterol (VLDL-C) and lipoprotein(a) were significantly higher in the smoking group than those in the non-smoking group (P＜0.05). SYNTAX score was significantly higher in the smoking group than that in the non-smoking group (P＜0.05). In patients with coronary single-vessel lesion and patients with multi-vessel lesions, the proportion of severe stenosis was significantly higher in smoking group than that in non-smoking group (P＜0.05). Logistic regression analysis showed that after adjusting confounding factors, patients in the smoking group faced a higher risk of a mid-high SYNTAX score (≥23, OR=3.000, 95%CI: 1.152-7.811) and coronary multi-vessel severe stenosis (OR=2.275, 95%CI: 1.098-4.713). Conclusion　Smoking is related with the severity of coronary lesions in male patients ≤45 years old with PMI, which significantly increases the risk of the mid-high SYNTAX score and coronary multi-vessel severe stenosis. 

Key words: smoking, male, coronary angiography, myocardial infarction, coronary stenosis, premature myocardial infarction, SYNTAX score

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