文献类型：期刊文献

中文题名：代谢综合征与冠心病冠状动脉病变相关性分析

英文题名：The correlation between metabolic syndrome and coronary artery lesions in patients with coronary heart disease

作者：李耀华[1];谢萍[2]

第一作者：李耀华

机构：[1]甘肃中医药大学临床医学院;[2]甘肃省人民医院心内科

第一机构：甘肃中医药大学临床医学院

年份：2017

卷号：9

期号：1

起止页码：41

中文期刊名：中国循证心血管医学杂志

外文期刊名：Chinese Journal of Evidence-Based Cardiovascular Medicine

收录：CSTPCD

基金：甘肃省生卫生行业科研计划项目(GSWSKY-2015-04)

语种：中文

中文关键词：冠心病;代谢综合征;冠状动脉病变;Gensini积分

外文关键词：Metabolic syndrome; Coronary heart disease; Coronary artery lesion; Gensini score

摘要：目的研究代谢综合征(MS)与冠状动脉粥样硬化性心脏病(冠心病,CHD)冠状动脉病变特征的相关性。方法连续入选2014年1月~2015年1月于甘肃省人民医院经冠状动脉造影检查确诊冠心病的患者434例,按照是否合并代谢综合征分为代谢综合征组(MS组)和非代谢综合征组(NMS组),依据冠状动脉病变支数、病变形态特点及Gensini积分对两组患者的冠状动脉造影结果进行评估,分析MS各组成部分及其他危险因素与Gensini积分和冠脉病变严重程度的关系。结果 MS组患者年龄、腰围、臀围、体重、体质指数(BMI)、收缩压(SBP)、舒张压(DBP)、空腹血糖(FPG)、糖化血红蛋白(Hb A1c)、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、尿酸(UA)、高敏C反应蛋白(hs-CRP)、同型半胱氨酸(Hcy)、双支及多支病变例数、复杂病变例数和Gensini积分高于NMS组,差异有统计学意义(P<0.01~0.05),高密度脂蛋白胆固醇(HDL-C)和总胆红素(TBIL)低于NMS组,差异有统计学意义(P<0.05);Pearson相关分析表明BMI、SBP、DBP、FPG、Hb A1c、TG、TC、LDL-C和UA与Gensini积分正相关(r=0.090~0.278,P<0.05),HDL-C和TBIL与Gensini积分负相关(r=-0.120、-0.097,P<0.05),Hcy和hs-CRP与Gensini积分无相关(r=0.090、0.098,P>0.05);Logistic回归分析示年龄、BMI、SBP、Hb A1c和TC是冠状动脉病变严重程度的独立危险因素(OR>1.0,P<0.05),HDL-C和TBIL是冠状动脉病变严重程度的保护因素(OR<1.0,P<0.05)。结论 MS患者有更高的CHD危险因素,更复杂和严重的冠状动脉病变程度,采取有效措施控制MS患者血糖、血脂、血压水平等危险因素,对于防治CHD尤为重要。
Objective To investigate the correlation between metabolic syndrome (MS) and characteristics of coronary artery lesions in patients with coronary heart disease (CHD). Methods From January 2014 to January 2015, 434 consecutive patients who diagnosed as CHD by coronary angiography were enrolled, they were divided into MS group and non-MS (NMS) group. The consequences of coronary angiography in two groups were evaluated according to the number of lesions, morphology of lesions and Gensini score. The correlation between MS components, Gensini score and severity of coronary artery were analyzed. Results Patient's age, waist circumference, hip circumference, body weight, body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting plasma glucose (FPG), glycosylated hemoglobin (HbA1c), total cholesterol (TC),triglyceride (TG), low density lipoprotein cholesterol LDL-C), uric acid (UA), high-sensitivity C-reactive protein (hs-CRP), homocysteine (Hcy), incidence of double or multiple lesions, cases of complex lesions and Gensini score were higher in MS group than that in NMS group, the differences were statistically significant (P<0.01 or 0.05);high-density lipoprotein cholesterol (HDL-C) and total bilirubin (TBIL) were lower in MS group than that in NMS group, the differences were statistically significant (P<0.05). Result of Pearson correlation analysis showed that FPG, HbA1c, SBP, DBP, TG, TC, LDL-C, UA were all positively correlated with the Gensini score (r=0.090-0.278,P<0.05), HDL-C and TBIL were negatively correlated with Gensini score (r=-0.120 and -0.097, P<0.05). Hcy and hs-CRP were not correlated with Gensini scores (r=0.090 and 0.098, P>0.05). Result of logistic regression analysis showed that the age, BMI, SBP, HbA1c and TC were the independent risk factors of the severity of coronary lesions (OR>1, P<0.05); HDL-C and TBIL were the protective factors of the severity of coronary lesions (OR<1,P<0.05). Conclusion MS patients have higher CHD risk factors, more complex and severe coronary artery lesions,taking effective measures to control the glucose, lipid, pressure levels and other risk factors of MS are particularly important for the prevention and treatment of CHD.