中国医药
中國醫藥
중국의약
CHINA MEDICINE
2014年
9期
1249-1253
,共5页
杨伟宪%杨铮%吴永健%乔树宾%杨跃进%陈纪林
楊偉憲%楊錚%吳永健%喬樹賓%楊躍進%陳紀林
양위헌%양쟁%오영건%교수빈%양약진%진기림
冠心病%青年%危险因素
冠心病%青年%危險因素
관심병%청년%위험인소
Coronary heart disease%Young people%Risk factors
目的:分析青年冠心病患者的危险因素。方法对2006年7-12月在阜外心血管病医院进行冠状动脉造影的292例青年患者(≤40岁)的病例资料进行回顾性分析,对比分析冠心病组(217例)和非冠心病组(75例)临床特征及相关实验室检查数据,分析青年冠心病患者的危险因素。结果被调查的292例青年患者中体重指数>24 kg/m2者占78.8%(230/292),吸烟者71.6%(209/292);饮食习惯中喜油腻饮食者55.5%(162/292)。冠心病组严重吸烟者(吸烟史超过10年,每天吸烟超过20支)的比例高[207.%(45/217)比9.2%(7/75),P=0.015]。与代谢和炎症相关的实验室检查数据分析表明,冠心病组血浆总胆固醇、低密度脂蛋白胆固醇、脂蛋白a、尿酸、红细胞沉降率以及大内皮素1水平明显高于非冠心病组[血浆总胆固醇:(4.6±1.5)mmol/L比(4.1±10.)mmol/L,低密度脂蛋白胆固醇:(2.4±1.1)mmol/L比(2.1±0.6)mmol/L,脂蛋白a:(135±110)mg/L比(102±58)mg/L,尿酸:(360±100)μmol/L比(337±94)μmol/L,5(2,13)mm/1 h比2(36,)mm/1 h;0.450(0.290,2.510)pmol/L比0.320(0.208,04.75)pmol/L],差异均有统计学意义(P<0.05或P<0.01),高敏C 反应蛋白差异无统计学意义[1.750(0.738,3.755) mg/L比12.80(0.550,2.71)mg/L](P>0.05)。多因素Logistic回归分析表明,吸烟[比值比(OR)=1.89,95%置信区间(CI):17.4~2.05],高血压(O R=1.56,95% CI:1.48~1.65),2型糖尿病(O R=1.37,95%CI:1.25~15.0),高脂饮食(OR=1.35,95%CI:1.28~1.43)和体重指数>24 kg/m2(OR=1.09,95% CI:1.03~1.17)和有饮酒史(OR=1.37,95% CI:1.30~1.46)的年轻人患冠心病的危险明显增加(均P<0.01)。结论在被调查的年龄≤40岁的青年患者中体重指数>24 kg/m2,吸烟,饮食习惯中喜油腻饮食比例非常高。青年冠心病患者的血浆血脂、尿酸水平明显异常,反映炎性的指标红细胞沉降率、高敏C反应蛋白和大内皮素1明显升高。吸烟过多、高血压、2型糖尿病、喜油腻饮食和体重指数>24 kg/m2和饮酒为青年冠心病患者的主要危险因素。
目的:分析青年冠心病患者的危險因素。方法對2006年7-12月在阜外心血管病醫院進行冠狀動脈造影的292例青年患者(≤40歲)的病例資料進行迴顧性分析,對比分析冠心病組(217例)和非冠心病組(75例)臨床特徵及相關實驗室檢查數據,分析青年冠心病患者的危險因素。結果被調查的292例青年患者中體重指數>24 kg/m2者佔78.8%(230/292),吸煙者71.6%(209/292);飲食習慣中喜油膩飲食者55.5%(162/292)。冠心病組嚴重吸煙者(吸煙史超過10年,每天吸煙超過20支)的比例高[207.%(45/217)比9.2%(7/75),P=0.015]。與代謝和炎癥相關的實驗室檢查數據分析錶明,冠心病組血漿總膽固醇、低密度脂蛋白膽固醇、脂蛋白a、尿痠、紅細胞沉降率以及大內皮素1水平明顯高于非冠心病組[血漿總膽固醇:(4.6±1.5)mmol/L比(4.1±10.)mmol/L,低密度脂蛋白膽固醇:(2.4±1.1)mmol/L比(2.1±0.6)mmol/L,脂蛋白a:(135±110)mg/L比(102±58)mg/L,尿痠:(360±100)μmol/L比(337±94)μmol/L,5(2,13)mm/1 h比2(36,)mm/1 h;0.450(0.290,2.510)pmol/L比0.320(0.208,04.75)pmol/L],差異均有統計學意義(P<0.05或P<0.01),高敏C 反應蛋白差異無統計學意義[1.750(0.738,3.755) mg/L比12.80(0.550,2.71)mg/L](P>0.05)。多因素Logistic迴歸分析錶明,吸煙[比值比(OR)=1.89,95%置信區間(CI):17.4~2.05],高血壓(O R=1.56,95% CI:1.48~1.65),2型糖尿病(O R=1.37,95%CI:1.25~15.0),高脂飲食(OR=1.35,95%CI:1.28~1.43)和體重指數>24 kg/m2(OR=1.09,95% CI:1.03~1.17)和有飲酒史(OR=1.37,95% CI:1.30~1.46)的年輕人患冠心病的危險明顯增加(均P<0.01)。結論在被調查的年齡≤40歲的青年患者中體重指數>24 kg/m2,吸煙,飲食習慣中喜油膩飲食比例非常高。青年冠心病患者的血漿血脂、尿痠水平明顯異常,反映炎性的指標紅細胞沉降率、高敏C反應蛋白和大內皮素1明顯升高。吸煙過多、高血壓、2型糖尿病、喜油膩飲食和體重指數>24 kg/m2和飲酒為青年冠心病患者的主要危險因素。
목적:분석청년관심병환자적위험인소。방법대2006년7-12월재부외심혈관병의원진행관상동맥조영적292례청년환자(≤40세)적병례자료진행회고성분석,대비분석관심병조(217례)화비관심병조(75례)림상특정급상관실험실검사수거,분석청년관심병환자적위험인소。결과피조사적292례청년환자중체중지수>24 kg/m2자점78.8%(230/292),흡연자71.6%(209/292);음식습관중희유니음식자55.5%(162/292)。관심병조엄중흡연자(흡연사초과10년,매천흡연초과20지)적비례고[207.%(45/217)비9.2%(7/75),P=0.015]。여대사화염증상관적실험실검사수거분석표명,관심병조혈장총담고순、저밀도지단백담고순、지단백a、뇨산、홍세포침강솔이급대내피소1수평명현고우비관심병조[혈장총담고순:(4.6±1.5)mmol/L비(4.1±10.)mmol/L,저밀도지단백담고순:(2.4±1.1)mmol/L비(2.1±0.6)mmol/L,지단백a:(135±110)mg/L비(102±58)mg/L,뇨산:(360±100)μmol/L비(337±94)μmol/L,5(2,13)mm/1 h비2(36,)mm/1 h;0.450(0.290,2.510)pmol/L비0.320(0.208,04.75)pmol/L],차이균유통계학의의(P<0.05혹P<0.01),고민C 반응단백차이무통계학의의[1.750(0.738,3.755) mg/L비12.80(0.550,2.71)mg/L](P>0.05)。다인소Logistic회귀분석표명,흡연[비치비(OR)=1.89,95%치신구간(CI):17.4~2.05],고혈압(O R=1.56,95% CI:1.48~1.65),2형당뇨병(O R=1.37,95%CI:1.25~15.0),고지음식(OR=1.35,95%CI:1.28~1.43)화체중지수>24 kg/m2(OR=1.09,95% CI:1.03~1.17)화유음주사(OR=1.37,95% CI:1.30~1.46)적년경인환관심병적위험명현증가(균P<0.01)。결론재피조사적년령≤40세적청년환자중체중지수>24 kg/m2,흡연,음식습관중희유니음식비례비상고。청년관심병환자적혈장혈지、뇨산수평명현이상,반영염성적지표홍세포침강솔、고민C반응단백화대내피소1명현승고。흡연과다、고혈압、2형당뇨병、희유니음식화체중지수>24 kg/m2화음주위청년관심병환자적주요위험인소。
Objective To discuss the risk factors of coronary heart disease ( CHD ) in young patients . Methods The study population included 292 young patients who underwent coronary angiography from July 2006 to December 2006 at Fuwai hospital .According to the coronary angiography , CHD was diagnosed as ≥50%diam-eter stenosis in coronary lumen .There were 217 patients in CHD group and 75 cases with normal coronary lumen in non-CHD group.Clinical data and metabolic characteristics were collected and analyzed .Results More than half of the study subjects had body mass index (BMI) of >24 kg/m2 (230/292,78.8%); current smokers were (209/292,71.6%) and had rich fatty diet (162/292,55.5%).More patients were heavy smokers (smoking his-tory more than 10 years and more than 20 cigarettes per day) in CHD group [20.7%(45/217)vs 9.2%(7/75), P=0.015].The metabolic data analysis showed that total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), lipoprotein(LP)a, uric acid (UA) in plasma were significantly increased in CHD group and higher than those in non-CHD group (P<0.05 or P<0.01)[TC:(4.6 ±1.5)mmol/L vs (4.1 ±1.0)mmol/L, LDL-C:(2.4 ±1.1)mmol/L vs (2.1 ±0.6) mmol/L,(LP)a: (135 ±110)mg/L vs (102 ±58)mg/L,UA:(360 ± 100)μmol/L vs (337 ±94)μmol/L].Compared with non-CHD group, the ESR and big endothelin-1 were signifi-cantly higher than those in CHD group [5(2,13)mm/1 h vs 2(3,6)mm/1 h;0.450(0.290, 2.510)pmol/L vs 0.320(0.208, 0.475)pmol/L] (P<0.05 or P<0.01).hs-CRP had not significant difference between two groups[1.750(0.738, 3.755)mg/L vs 1.280(0.550, 2.71)mg/L](P>0.05).Multinomial logistic regression showed that significant risk factors (all P<0.01) included heavy smoking [odds ratio (OR)=1.89, 95%confi-dence interval (CI):1.74-2.05], hypertension (OR=1.56, 95% CI:1.48-1.65),alcohol (OR=1.37, 95%CI:1.30-1.46), diabetes (OR=1.37, 95%CI:1.25-1.50), rich fatty diet (OR=1.35, 95%CI:1.28-1.43) and BMI>24 kg/m2(OR=1.09, 95%CI:1.03-1.17).Conclusions Young people (age≤40) have a high pro-portion of BMI >24 kg/m2 , current smokers and rich fatty diet .The metabolic characteristics , including TC, LDL-C, LP(a), UA are unusual.ESR, hs-CRP and big endothelin-1 in plasma significantly increase in CHD group.Heavy smoker, hypertension, alcohol, diabetes, rich fatty diet and BMI>24 kg/m2 are significant risk fac-tors of CHD in these patients .