江立生,邵琴,卜军,何奔

• 1:上海交通大学医学院附属仁济医院心内科

摘要(Abstract)：

目的对临床上冠心病患者合并传统心血管病危险因素进行分析。方法纳入本中心2013年1月至2015年2月因冠心病或疑似冠心病行冠状动脉造影(CAG)检查的住院患者,将存在严重冠心病并接受经皮冠状动脉介入治疗(PCI)的患者归为PCI组(2808例),不存在严重冠心病且未行PCI/冠状动脉旁路移植术(CABG)的患者归为No-PCI/CABG组(3232例)。PCI组再分为急性ST段抬高心肌梗死(STEMI)组、非ST段抬高急性心肌梗死/不稳定型心绞痛(NSTEMI/UA)组和稳定型心绞痛(SA)组。对临床上合并的传统心血管病危险因素进行回顾性分析。结果 (1)PCI组患者男性比例(75.4%比53.1%,P<0.0001)、平均年龄[(64.83±0.20)岁比(63.39±0.18)岁,P<0.0001]、高血压病(66.7%比54.7%,P<0.0001)、糖尿病/糖耐量异常(37.0%比20.8%,P<0.0001)、卒中(7.0%比5.4%,P=0.0098)和慢性肾病(4.3%比2.8%,P=0.001)比例显著高于NoPCI/CABG组;而两组间高脂血症的比例,差异无统计学意义(P>0.05)。(2)PCI组中女性高血压病(74.1%比64.3%,P<0.0001)、糖尿病/糖耐量异常(42.5%比35.3%,P=0.0007)和卒中(9.4%比6.2%,P=0.0054)比例均显著高于男性,差异均有统计学意义;无论PCI组还是No-PCI/CABG组,女性高脂血症比例均显著高于男性。(3)对PCI组进行亚组分析发现,STEMI组男性比例显著高于NSTEMI/UA组和SA组(83.9%比72.9%比72.3%,P<0.0001),而发病年龄显著小于NSTEMI/UA组和SA组[(62.54±0.45)岁比(65.15±0.28)岁比(66.17±0.34)岁,P<0.0001]。SA组高血压病(71.9%比66.9%比60.0%,P<0.0001)和既往靶血管血运重建(PCI/CABG)(33.9%比18.7%比7.2%,P<0.0001)比例显著高于STEMI组和NSTEMI/UA组;NSTEMI/UA组糖尿病/糖耐量异常比例显著高于STEMI组和SA组(39.7%比35.1%比34.4%,P<0.0001),差异均有统计学意义;而高脂血症、慢性肾病和卒中的比例三亚组间差异无统计学意义(P>0.05)。结论高血压病和糖尿病是冠心病最重要的危险因素,既往靶血管血运重建是SA和NSTEMI/UA患者靶血管再次血运重建的重要原因;行PCI的严重冠心病患者中,男性比例高于女性,但女性合并高血压病、糖尿病/糖耐量异常和卒中的比例高于男性。

关键词(KeyWords)： 冠心病;介入治疗;危险因素;回顾性分析

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 江立生,邵琴,卜军,何奔

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