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早发严重冠状动脉三支病变患者冠心病危险因素的分布及聚集

牛海芳1,车京津2,3,邵元霞1,3,甘慧敏1,3   

  1. 1. 天津医科大学
    2. 天津医科大学附属第二医院心脏科
    3.
  • 收稿日期:2010-10-08 修回日期:2011-01-12 出版日期:2011-05-15 发布日期:2011-05-15
  • 通讯作者: 牛海芳

Clustering Status of the Risk Factors for Premature Severe Three-vessel Coronary Disease

  • Received:2010-10-08 Revised:2011-01-12 Published:2011-05-15 Online:2011-05-15
  • Contact: NIU hai fang

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摘要： 【摘要】 目的：探讨早发严重冠状动脉（冠脉）三支病变患者已知冠心病危险因素的分布及聚集，为年轻人防治冠脉严重病变提供依据。方法：对比冠脉造影证实的早发严重冠脉三支病变患者（病变组）113例与冠脉正常患者（对照组）57例的临床资料，分析危险因素聚集情况并筛选早发严重冠脉三支病变的独立危险因素。结果：（1）两组之间男性、吸烟史、甘油三脂（TG）、高密度脂蛋白胆固醇（HDL-C）、肥胖、高血压病史、糖尿病史、冠心病家族史差异显著（P<0.05～<0.01），其危险性程度依次为性别（男性），低HDL-C血症，吸烟，高TG血症，高血压，肥胖，糖尿病（OR值分别为10.28，6.65，5.26，4.42，3.34，2.70，2.68）。多元Logistic回归分析显示影响早发严重冠脉三支病变的危险因素有性别（男性）、家族史、糖尿病史、高TG血症及低HDL-C血症。（2）病变组与对照组比较，3种以上危险因素聚集程度明显增加。（3）亚组分析显示吸烟史、家族史、体重指数、HDL-C与男性严重冠脉三支病变显著相关，糖尿病史、高TG血症、高血压、HDL-C与女性显著相关（P<0.05）。结论：性别（男性）、家族史、糖尿病史、高TG血症及低HDL-C血症是早发严重冠脉三支病变的独立危险因素，且此类患者存在多种危险因素聚集现象。男女间危险因素的分布存在显著差异。

关键词: 早发, 三支病变, 冠脉, 危险因素, 聚集

Abstract: 【Abstract】 Objective：To investigate the clustering status of the known cardiovascular risk factors for premature severe three-vessel coronary artery lesions．Methods：Following coronary angiography, 113 patients with severe three-vessel coronary artery lesions（the disease group）and another 55 patients with normal coronary artery（the control group）enrolled in the study. Clinical datas and distribution of the risk factors were analyzed．Results：（1） It was significantly different among the gender, smoking, triglyceride, high-density-lipoprotein- cholesterol（HDL-C）, obesity, hypertension, diabetes mellitus and positive family history（PFH）between the groups（P<0.05～<0.01）. The sequential contribution of the main risk factors to premature three-vessel coronary artery lesions was that gender（male）, low HDL-C, smoking, hypertriglyceridemia, hypertension, obesity and diabetes mellitus（with a OR of 10.28, 6.65, 5.26, 4.42, 3.34, 2.70, 2.68 respectively）.Multiple logistic regression analysis showed the remarkable correlation between the gender（male）, PFH, diabetes mellitus, hypertriglyceridemia, low HDL-C and the three-vessel coronary lesions. （2）Compared with the control group, clustering extent of any three risk factors or more was remarkably higher in disease group.（3）Subgroup analysis indicated that smoking, PFH, body mass index and HDL-C was associated significantly with male disease group as well as diabetes mellitus, hypertriglyceridemia, hypertension and HDL-C with female group（P<0.05）.Conclusion：Gender（male）, PFH, diabetes mellitus, low HDL-C and hypertriglyceridemia were independent risk factors for the premature severe three-vessel coronary artery lesions and the clustering of the main risk factors existed. The distribution of risk factors was remarkably different between gender.

Key words: premature, three-vessel coronary lesion, risk factors, clustering