CAJ | 학술논문

目的：探讨腹型肥胖对急性冠脉综合征（ ACS）患者冠状动脉病变严重程度的影响。方法收集ACS患者109例，以腰围/身高比值（WHtR）0．5为切点，分为腹型肥胖组（AO组，WHtR≥0．5）和非腹型肥胖组（NAO组，WHtR＜0．5）。所有患者均进行冠状动脉造影，应用Gensini积分系统对每支血管狭窄程度进行定量分析，并根据冠状动脉受累的主要支数，将所有受试者分为单支（39例）、双支（43例）和三支病变（27例）组。比较AO组与NAO组的ACS患者临床指标及Gensini积分水平变化；比较单支、双支和三支病变组的WHtR，分析WHtR与Gensini积分水平的相关性。结果 AO组较NAO组体质量指数、腰围、收缩压、空腹血糖、三酰甘油、总胆固醇、低密度脂蛋白胆固醇及Gensini积分显著性增高，而高密度脂蛋白胆固醇则显著性降低；单支、双支和三支病变组的WHtR差异有统计学意义（F＝5．94，P＜0．05），双支组与单支组差异无统计学意义（q＝0．79，P＞0．05），三支组高于单支组（q＝4．90，P＜0．05）和双支组（q＝3．31，P＜0．05）。多元线性回归分析显示WHtR是ACS患者Gensini积分的独立危险因素。结论 ACS患者WHtR的增高与其冠脉病变严重程度密切相关，有效地控制AO对减少心血管疾病的发病率及减轻冠状动脉病变程度有着重要意义。
목적：탐토복형비반대급성관맥종합정（ ACS）환자관상동맥병변엄중정도적영향。방법수집ACS환자109례，이요위/신고비치（WHtR）0．5위절점，분위복형비반조（AO조，WHtR≥0．5）화비복형비반조（NAO조，WHtR＜0．5）。소유환자균진행관상동맥조영，응용Gensini적분계통대매지혈관협착정도진행정량분석，병근거관상동맥수루적주요지수，장소유수시자분위단지（39례）、쌍지（43례）화삼지병변（27례）조。비교AO조여NAO조적ACS환자림상지표급Gensini적분수평변화；비교단지、쌍지화삼지병변조적WHtR，분석WHtR여Gensini적분수평적상관성。결과 AO조교NAO조체질량지수、요위、수축압、공복혈당、삼선감유、총담고순、저밀도지단백담고순급Gensini적분현저성증고，이고밀도지단백담고순칙현저성강저；단지、쌍지화삼지병변조적WHtR차이유통계학의의（F＝5．94，P＜0．05），쌍지조여단지조차이무통계학의의（q＝0．79，P＞0．05），삼지조고우단지조（q＝4．90，P＜0．05）화쌍지조（q＝3．31，P＜0．05）。다원선성회귀분석현시WHtR시ACS환자Gensini적분적독립위험인소。결론 ACS환자WHtR적증고여기관맥병변엄중정도밀절상관，유효지공제AO대감소심혈관질병적발병솔급감경관상동맥병변정도유착중요의의。
Objective To study the correlation between waist to height ratio ( WHtR) and the severity of coronary artery disease in the patients with acute coronary syndrome (ACS).Methods A total of 109 ACS patients were divided into two groups-AO group(WHtR≥0.5,n=58) and NAO group(WHtR<0.5,n=51).Coronary artery angiography was performed in all patients .According to results of coro-nary angiography ,Gensini scores were calculated to quantize the severity of coronary arterial stenosis .All the patients were divided into three groups (one-vessel,two-vessels,three-vessels) according to numbers of affected vessels .The clinical data and Gensini scores were compared between the AO group and the NAO group ,and WHtR values were compared respectively among the three groups ( one-vessel,two-vessels, three-vessels).Furthermore,the correlation between WHtR and Gensini scores was analyzed .Results Comparison of the clinical data and Gensini scores between the AO group and NAO group showed that body mass index (BMI),waist circumference,SBP,FBG,TG,TC,LDL-C and Gensini scores were significantly higher in the AO group ,while HDL-C was significantly lower in the AO group .WHtR values were signifi-cantly different among the one-vessel,two-vessels and three-vessels groups(F=5.94,P<0.05),with the three-vessels group higher than the one-vessel group(q=4.90,P<0.05) and the two-vessels group(q=3.31,P<0.05).Multiple linear regression analysis showed that WHtR was a significant independent predictor for Gensini scores in patients with ACS .Conclusions The increasing of WHtR is intimately and posi-tively correlated with the severity of coronary artery disease in patients with ACS .