冠狀動脈狹窄程度與冠心病危險因素相關分析

摘要：目的 探討冠狀動脈狹窄程度與冠心病危險因素的相關性。方法 連續性收集我科行冠狀動脈造影的患者296例，根據造影結果，將患者分為冠心病組181例與對照組115例。收集2組患者臨床、實驗室和影像學資料，采用單因素和多因素logistic回歸模型進行分析。結果 冠心病組高血壓、糖尿病、吸煙比例均高于對照組 （P<0.05）；多因素logistic回歸分析示，高血壓（OR=1.868，P=0.030）、吸煙（OR=1.755，P=0.029）是冠心病的獨立危險因素。中、重度冠狀動脈狹窄患者男性、糖尿病、吸煙比例均高于輕度狹窄者（P<0.05）；logistic回歸分析示，糖尿病（OR=2.363，P=0.011）、吸煙（OR=2.659，P=0.022）與冠狀動脈狹窄程度相關。結論 冠心痛的危險因素與冠狀動狹窄程度存在顯著相關性，其中吸煙是兩者共同的重要危險因素。

關鍵詞：冠狀動脈狹窄；冠心病危險因素；吸煙

Abstract：Objective To exploe the correlation between coronary artery stenosis and risk factors for coronary heart disease（CHD）.Methods A total 296 of patients were divided into CHD group（n=181）and control group（n=115）according to their coronary angiography。Their clinical，laboratory and imaging data were analyzed by univariate and multivariate logistic regression analysis.Results The proportions of hypertension，diabetes and smoker were significantly higher in CHD group than in control group（P<0.05）.Multivariate logistic regression analysis showed that hypertension and smoking were the independent risk factors for CHD（0R=1.868，P=0.030；OR=1.755，P=0.029）.The number of smokers and diabetes was greater in moderate and severe coronary artery stenosis patients than in mild coronary artery stenosis patients （P<0.05）.Logistic regression analysis showed that diabetes and smoking were the risk factors for coronary artery stenosis（OR=2.363，P=0.011；OR=2.659，P=0.022）.Conclusion Risk factors for CHD are closely related with coronary artery stenosis. Smoking is an important risk factor for both CHD and coronary artery stenosis.

Key words：Coronary stenosis；Coronary disease risk factors；Smoking

包括中國在內的發展中國家，冠心病的發病率及死亡率逐年上升，并逐漸成為主要死亡原因。冠心病的一級預防應該成為衛生工作重點，一級預防工作中需要準確的識別并評估心血管事件中的高風險因素，并做出措施[1]。傳統危險因素（高血壓病、糖尿病、高脂血癥、吸煙）在冠心病進程中作用基本明確[2]。新的危險因素如：胰島素抵抗、感染、脂蛋白a等不斷被提出，但其與冠狀動脈狹窄的相關性仍存在爭議。危險因素相互之間并不只是簡單的疊加而是倍數關系，危險因素有2個或2個以上時，冠心病發病率顯著行增加。本研究收集冠狀動脈造影術者危險因素，并對其與冠心病相關性進行分析。

1 資料與方法

1.1一般資料 2014年12月1日～2015年11月30日在我院心血管內科住院、并行冠狀動脈造影術者296例，男性163例，女性133例，平均年齡（64.12±9.32）歲。……