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《慢性病学杂志》[ISSN:1674-8166/CN:11-5900/R]

卷:

期数:

2016年03期

页码:

251-255

栏目:

论著

出版日期:

2016-06-02

文章信息/Info

Title:

Risk factors, angiographic findings and characteristics of early onset coronary heart disease patients

作者:

王伟;  曹新营;  白华;  王志军

华北理工大学附属医院，河北唐山063015

Author(s):

WANG Wei;  CAO Xin-ying;  BAI Hua;  WANG Zhi-jun

Department of Cardiology, Affiliated Hospital of North China Polytechnic University, Tangshan, Hebei 063000, China Corresponding author: WANG Zhi-jun, E-mail: wzj300@163.com

关键词:

早发冠心病; 危险因素; 冠脉造影; C 反应蛋白; 半乳酸凝集素-3

Keywords:

Premature coronary heart disease;  Risk factors;  Coronary angiography;  C- reactive protein;  Galectin-3

分类号:

R541.4

DOI:

-

摘要:

目的探讨早发冠心病患者危险因素、血管造影结果以及发病特点，进一步研究早发冠心病超敏C 反应蛋白（hs-CRP）、半乳酸凝集素-3 （Gal-3） 的关系。方法选取2014 年11 月至2015 年11 月在华北 理工大学附属医院心内科住院的207 例进行冠状动脉造影确诊为冠心病的患者，依据年龄分为早发冠心病 组（男性年龄＜55 岁，女性＜65 岁） 和晚发冠心病组（男性＞55 岁，女性＞65 岁），分别进行一般情况调 查、既往病史调查及体格检查， 并对所有患者临床资料及血清生化指标、CRP、Gal-3 进行记录分析对 比。结果吸烟（42.7% vs 28.8%，P=0.037），男性（67.8% vs 47.1%，P=0.002），冠心病家族史（34.0% vs 14.4%， P=0.001）， BMI[(26.12 ± 4.1) vs (25.08 ± 2.9) kg/m2， P=0.041]， 血清总胆固醇（TC） [(5.28 ± 1.32) vs (4.83±1.16) mmol/L，P=0.041]，血清甘油三酯（TG） [(2.31±2.07) vs (1.65±1.14) mmol/L，P= 0.005]，低密度脂蛋白（LDL-C） [(3.15±0.98) vs (2.83±0.78) mmol/L，P=0.023]在早发冠心病组更为流 行；而2 型糖尿病（14.6% vs 26.9%，P=0.039） 和高血压（50.5% vs 64.4%，P=0.049） 则在晚发冠心病 组的发病率更高。早发冠心病组和晚发冠心病组Gal-3 水平分别为（6.89±2.88） 和（6.07±2.06） μg/L， P=0.021； 同型半胱氨酸（Hcy） 分别为（12.9 ± 5.7） 和（11.0 ± 5.9） μmol/L， P=0.020； CRP 分别为 （6.5±4.9） 和（4.9±4.3） mg/L，P=0.015。早发冠心病中急性冠脉综合征（ACS） 发病人数明显超过晚发 冠心病（25.2% vs 13.4% ， P=0.036）。在早发冠心病组单支血管病变占有优势（65.0% vs 40.4% ， P＜ 0.001）。在矫正了高脂血症、BMI、性别、吸烟、冠心病家族史危险因素后，Gal-3 仍然是早发冠心病的 独立危险因素（OR=1.155，95%CI 1.025~1.302，P=0.018）。结论吸烟、肥胖、男性、血脂紊乱以及冠 心病家族史在早发冠心病中更为常见，早发冠心病血管病变以单支病变为主，早发冠心病以ACS 方式起病 常见，Gal-3 是早发冠心病的独立危险因素。

Abstract:

Objective To investigate the risk factors, angiographic findings and the characteristics of early onset coronary heart disease (CHD) patients, and study the relationship between high-sensitivity c-reactive protein (hs- CRP), Galectin- 3 (Gal- 3) and CHD. Methods From November 2014 to November 2015, 207 patients with stable angina or acute coronary syndrome diagnosed with coronary angiography in the Department of Cardiology of the Affiliated Hospital of North China University were chosen. According to the age, patients were divided into premature CHD group (male age＜55 years, female＜65 years) and late-onset CHD (male age＞55 years, female＞65 years). The general situation investigation, past medical history investigation and physical examination were carried out, and the clinical data and serum biochemical parameters, hs- CRP, Gal- 3 were analyzed and compared. Results Smoking (42.7% vs 28.8%, P=0.037), male (67.8% vs 47.1%, P=0.002), family history of coronary heart dis-ease (34.0% vs 14.4%, P=0.001), BMI (26.12±4.1 vs. 25.08±2.9 kg/m2, P=0.041), TC (5.28±1.32 vs 483 ± 1.16 mmol/L, P=0.041), TG (2.31 ± 2.07 vs 1.65 ± 1.14 mmol/L, P=0.005) in premature CHD group were more popular. Gal-3 (6.89±2.88 vs 6.07±2.06 μg/L, P=0.021), homocysteine (Hcy) (12.9± 5.7 vs 11.0±5.9 μmol/L, P=0.020) and hs-CRP (6.5±4.9 vs 4.9±4.3 mg/L, P=0.015) in premature CHD group increased significantly. The incidence of acute coronary syndrome (ACS) in patients with premature CHD was significantly higher than that of late onset CHD (25.2% vs 13.4%, P=0.036). In the premature CHD group, single vessel disease had the advantage (65.0% vs 40.4%, P<0.001). Gal-3 was still an independent risk factor for early onset CHD (OR=1.155, 95%CI 1.025-1.302, P=0.018) in the treatment of hyperlipidemia, BMI, gender, smoking, and family history of CHD. Conclusions Smoking, obesity, male, dyslipidemia, and family history of CHD are more common in the early onset of CHD. Single branch lesion and ACS are in the majority. Gal-3 is an independent risk factor for premature CHD.

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备注/Memo

备注/Memo:

基金项目：河北省教育厅课题（Z2012160） 作者简介：王伟，研究生，医师，研究方向：老年冠心病患者临床与基础研究 通信作者：王志军，E-mail: wzj300@163.com

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更新日期/Last Update: 2016-05-27