文章摘要
王莉娜,智 宏,钱莎莎,张佳菊,孟 醒,王炎炎,张 钰,朱 一,王 蓓.早发冠心病与晚发冠心病的危险因素和病变特点比较研究[J].南京医科大学学报,2012,(4):514~519
早发冠心病与晚发冠心病的危险因素和病变特点比较研究
A comparative study on the risk factors and the features of coronary lesions between patients with premature and mature coronary artery disease
投稿时间:2011-12-03  
DOI:10.7655
中文关键词: 冠心病  危险因素  血脂代谢  冠脉病变特点
英文关键词: coronary artery disease  risk factors  lipid metabolism  coronary artery lesions
基金项目:国家自然科学基金青年项目(30901230)
作者单位
王莉娜 东南大学公共卫生学院流行病与卫生统计学系,环境医学工程教育部重点实验室,江苏 南京 210009 
智 宏 东南大学附属中大医院心血管内科,江苏 南京 210009 
钱莎莎 东南大学公共卫生学院流行病与卫生统计学系,环境医学工程教育部重点实验室,江苏 南京 210009 
张佳菊 东南大学附属中大医院心血管内科,江苏 南京 210009 
孟 醒 东南大学公共卫生学院流行病与卫生统计学系,环境医学工程教育部重点实验室,江苏 南京 210009 
王炎炎 东南大学公共卫生学院流行病与卫生统计学系,环境医学工程教育部重点实验室,江苏 南京 210009 
张 钰 东南大学公共卫生学院流行病与卫生统计学系,环境医学工程教育部重点实验室,江苏 南京 210009 
朱 一 东南大学公共卫生学院流行病与卫生统计学系,环境医学工程教育部重点实验室,江苏 南京 210009 
王 蓓 东南大学公共卫生学院流行病与卫生统计学系,环境医学工程教育部重点实验室,江苏 南京 210009 
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中文摘要:
      目的:探讨早发冠心病(CAD)和晚发CAD的危险因素?血脂代谢情况和冠状动脉病变特点?方法:524例行冠状动脉造影(CAG)检查确诊CAD的患者按发病年龄分为早发冠心病组(男性<55岁,女性<65岁)和晚发冠心病组,另外CAG检查确定非冠心病个体112例作为对照组?收集临床资料和血管造影结果,比较3组的危险因素?血脂代谢情况和冠状动脉病变特点?结果:3组总体比较,性别?年龄?吸烟?父亲冠心病史?母亲高血压史?白细胞计数?红细胞计数和血清肌酐水平在3组人群中的分布差异有统计学意义(P < 0.05);早发与晚发CAD相比,父亲冠心病史?白细胞计数?红细胞计数和肌酐水平差异有统计学意义(P < 0.05);早发CAD组血清总胆固醇(TC)?甘油三酯(TG)?低密度脂蛋白胆固醇(LDL-C)均显著高于晚发CAD组?冠状动脉病变特点:早发CAD以单支血管病变为主,且冠脉狭窄程度重度者(> 90%)者少于晚发CAD?多分类Logistic回归分析提示,吸烟可增加早发和晚发CAD的风险,女性和母亲高血压史可减少晚发CAD的风险?结论:吸烟?心血管病家族史阳性(父亲冠心病史)?血脂代谢异常?血流动力学指标异常等可能是早发CAD的危险因素?早发CAD病变程度轻于晚发CAD,但预后差?应开展针对性的人群预防,加强早发CAD危险因素的综合防治,同时加强对女性早发冠心病患者的重视?
英文摘要:
      Objective:To explore the features of coronary lesions and cardiovascular risk factors in patients with premature and mature coronary artery disease(CAD). Methods:Total 524 patients who were diagnosed with CAD by coronary angiography(CAG) were divided into pCAD (male <55 year-old,female <65 year-old) and mature CAD. Another 112 patients without CAD diagnosed by CAG were considered as the control group. The risk factors,lipid metabolism levels and the coronary angiographic characteristics among the three groups were statistically analyzed. Results:Among the three groups,the distributions of the female,age,smoking status,father’s history of CAD,mother’s history of high blood pressure,white blood cells(WBC) counts,red blood cells (RBC) counts and creatinine concentration were significantly different(P < 0.05). For the pCAD and mature CAD groups,the distributions of father’s history of CAD,WBC counts,RBC counts and creatinine concentration were significantly different(P < 0.05). Serum total cholesterol(TC),triglyceride(TG) and low density lipoprotein cholesterol(LDL-C) levels in pCAD groups were significantly higher than those in mature CAD group. Most of pCAD patients had one vascular lesion,and the number of patients with serious coronary artery stenosis (>90%) in pCAD group was less than mature CAD group. Multinomial Logistic regression analysis showed that smoking was associated with the increased risk of both pCAD and mature CAD,while female and mother’s hypertension history were associated with the decreased risk of mature CAD. Conclusion:Smoking,positive family history of CAD,dyslipidemia and abnormal hemodynamics might be the possible risk factors of pCAD. The risk factors of pCAD should be prevented comprehensively,especially in female.
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