CAJ | 학술논문

目的：探讨冠心病患者腰身指数（WHtR）、血尿酸（UA）与冠状动脉病变程度的关系，为冠心病的预防及治疗提供根据和研究材料。方法对650例拟诊为冠心病且行冠状动脉造影患者进行身高、腰围、WHtR、血压及血UA的测定。根据冠状动脉造影的诊断结果将650例患者分为单支病变组（单支组，134例）、2支病变组（2支组，174例）、3支病变组（3支组，127例）和正常组（215例）。按照WHtR及血UA值分为WHtR＞0．5组、WHtR≤0．5组及尿酸≥420μmol·L-1组、尿酸＜420μmol·L-1组。根据冠状动脉病变程度计算冠状动脉 Gensini 积分。结果单因素分析结果：各组年龄、WHtR、腰围、肱动脉 SBP、肱动脉 DBP、CHOL（胆固醇）、血 UA、GLU（血糖）、LDL（低密度脂蛋白）、吸烟史、糖尿病史、高血压史等比较差异均有统计学意义（均P＜0．01）。多元直线逐步回归分析结果：将 Gensini积分行平方根转化后作为因变量，以单因素分析后挑选出P＜0．05的变量作为自变量，行多元直线逐步回归分析，结果表明在排除多种因素的相互影响后，WHtR、血清 UA、LDL、吸烟史、糖尿病史、高血压史对冠状动脉的病变程度有独立的预测价值（P＜0．001或P＜0．05）。各组间 Gensini积分比较结果表明，随着WHtR和血 UA水平的升高，Gensini 积分也逐渐升高，即冠状动脉病变程度也逐渐加重（P＜0．01）。结论WHtR结合血 UA检测可以很好地预测冠心病患者冠状动脉病变程度。
목적：탐토관심병환자요신지수（WHtR）、혈뇨산（UA）여관상동맥병변정도적관계，위관심병적예방급치료제공근거화연구재료。방법대650례의진위관심병차행관상동맥조영환자진행신고、요위、WHtR、혈압급혈UA적측정。근거관상동맥조영적진단결과장650례환자분위단지병변조（단지조，134례）、2지병변조（2지조，174례）、3지병변조（3지조，127례）화정상조（215례）。안조WHtR급혈UA치분위WHtR＞0．5조、WHtR≤0．5조급뇨산≥420μmol·L-1조、뇨산＜420μmol·L-1조。근거관상동맥병변정도계산관상동맥 Gensini 적분。결과단인소분석결과：각조년령、WHtR、요위、굉동맥 SBP、굉동맥 DBP、CHOL（담고순）、혈 UA、GLU（혈당）、LDL（저밀도지단백）、흡연사、당뇨병사、고혈압사등비교차이균유통계학의의（균P＜0．01）。다원직선축보회귀분석결과：장 Gensini적분행평방근전화후작위인변량，이단인소분석후도선출P＜0．05적변량작위자변량，행다원직선축보회귀분석，결과표명재배제다충인소적상호영향후，WHtR、혈청 UA、LDL、흡연사、당뇨병사、고혈압사대관상동맥적병변정도유독립적예측개치（P＜0．001혹P＜0．05）。각조간 Gensini적분비교결과표명，수착WHtR화혈 UA수평적승고，Gensini 적분야축점승고，즉관상동맥병변정도야축점가중（P＜0．01）。결론WHtR결합혈 UA검측가이흔호지예측관심병환자관상동맥병변정도。
Objective To explore the relationships of waist to height ratio(WHtR)and serum uric acid(UA)to the severity of coronary artery lesions in patients with coronary heart disease (CHD),and to provide the evidence and information for the prevention and treatment of CHD. Methods The height,waist,WHtR,blood pressure and serum UA levels were determined in 650 patients preliminarily diagnosed as having CHD who underwent coronary angiography.According to the results of coronary angiography,these patients were divided into singe-branch lesion group (n=134),double-branch lesion group(n=174),triple-branch lesion group(n=127)and normal group(n=215 ).According to WHtR and serum UA levels,these patients were divided into WHtR>0.5 group,WHtR≤0.5 group,UA≥420μmol·L-1 group and UA<420μmol·L-1group.The coronary artery Gensini score was calculated according to the severity of coronary ar-tery lesions.Results Univariate analysis showed that the differences in the age,WHtR,waist, systolic blood pressure(SBP),diastolic blood pressure(DBP),cholesterol(CHOL),UA,glucose (GLU),low density lipoprotein(LDL)and history of smoking,diabetes mellitus and hypertension were significant among different groups(all P<0.01).Taking the square root value of Gensini score as dependent variable and the variables of P<0.05 screened by univariate analysis as inde-pendent variable,multiple linear stepwise regression analysis was conducted.The results showed that the WHtR,serum UA,LDL and history of smoking,diabetes mellitus and hypertension had independent predictive values for j udging the severity of coronary artery lesions after excluding the influences of different factors on each other(P<0.001 or P<0.05).The comparison of Gensini scores among groups showed that Gensini scores and severity of coronary artery lesions increased with the increase of WHtR and serum UA levels(P<0.01).Conclusion The combined detection of WHtR and serum UA can predict the severity of coronary artery lesions.